Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1988-10-03
- Stop
- 1988-10-03
The parties
- Patient
- patient Sha Robin Reilly
- Provider
- provider Dale Mertz
- Payer
- payer Medicaid
Record id
043d6e13-0cc7-07f3-e057-f9fc0e589df9