Claim total
$5,732.65
base $155.66 · payer covered $5,682.65
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2018-09-02
- Stop
- 2018-09-02
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-ef3c-1e11d33e49ab