Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2005-01-12
- Stop
- 2005-01-12
The parties
- Patient
- patient Ivonne Senger
- Provider
- provider Pasquale Grimes
- Payer
- payer Medicaid
Record id
227fef4b-368a-4c5e-cc49-504f346be2e3