Claim total
$566.96
base $155.66 · payer covered $531.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2013-07-14
- Stop
- 2013-07-14
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Adrienne Hills
- Payer
- payer Dual Eligible
Record id
03e24eff-3793-eaeb-b79f-418336114a8d