Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2013-03-17
- Stop
- 2013-03-17
The parties
- Patient
- patient Ramona Schinner
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
032000cf-30b4-7e9b-76ee-3eaf7a8362d7