Claim total
$5,038.15
base $155.66 · payer covered $4,988.15
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-05-06
- Stop
- 2017-05-06
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-e21a-88bae8b6f0b4