Claim total
$15,987.60
base $155.66 · payer covered $15,937.60
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2020-01-09
- Stop
- 2020-01-09
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Dale Mertz
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-96e4-5b67f162171e