Claim total
$5,689.22
base $155.66 · payer covered $5,639.22
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-12-31
- Stop
- 2017-12-31
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-86dd-592052a31ee9