Claim total
$11,351.43
base $155.66 · payer covered $11,301.43
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2019-09-10
- Stop
- 2019-09-10
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-91fd-397ce62b4a9e