Claim total
$8,094.52
base $155.66 · payer covered $8,044.52
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2016-10-29
- Stop
- 2016-10-29
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
03e24eff-3793-eaeb-c6d4-518207ff310f