Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2005-05-14
- Stop
- 2005-05-14
The parties
- Patient
- patient Lincoln Moses Mueller
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
1d55f8ae-f39b-a58c-b008-93322f7ca34a