Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2021-01-20
- Stop
- 2021-01-20
The parties
- Patient
- patient Amado Antwan Botsford
- Provider
- provider Hassie Beer
- Payer
- payer Medicaid
Record id
2217599d-1482-7c06-859b-1b5f45fb86a1