Claim total
$5,038.15
base $155.66 · payer covered $4,988.15
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2018-09-28
- Stop
- 2018-09-28
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-b273-68f7f64373c2