Claim total
$9,566.69
base $155.66 · payer covered $9,516.69
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-05-25
- Stop
- 2017-05-25
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Hassie Beer
- Payer
- payer Medicaid
Record id
03e24eff-3793-eaeb-1f6e-2b9ad77abc0c