Claim total
$5,038.15
base $155.66 · payer covered $4,988.15
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-01-06
- Stop
- 2017-01-06
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
03e24eff-3793-eaeb-da2e-3fdb542d5c74