Claim total
$5,866.19
base $155.66 · payer covered $5,816.19
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-04-11
- Stop
- 2017-04-11
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Hassie Beer
- Payer
- payer Medicaid
Record id
03e24eff-3793-eaeb-bca2-ee33bf0c6a43