Claim total
$566.96
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2014-08-19
- Stop
- 2014-08-19
The parties
- Patient
- patient Kieth Ron Mertz
- Provider
- provider Dale Mertz
- Payer
- payer Aetna
Record id
0f52457a-32da-8b47-aa4e-c58069bf6bbb