Claim total
$5,443.11
base $155.66 · payer covered $5,393.11
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2016-12-14
- Stop
- 2016-12-14
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
03e24eff-3793-eaeb-54d0-57c2a79be94a