Claim total
$19,237.48
base $155.66 · payer covered $19,187.48
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2019-01-16
- Stop
- 2019-01-16
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-6cc4-e296ae990245