Claim total
$9,057.63
base $155.66 · payer covered $9,007.63
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2019-04-28
- Stop
- 2019-04-28
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-7cc1-039517cdf18c