Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2019-05-29
- Stop
- 2019-05-29
The parties
- Patient
- patient Emile Lawerence Lesch
- Provider
- provider Dale Mertz
- Payer
- payer Medicaid
Record id
2fda87fd-29fd-b4f1-43fe-41eb9c8f7266