Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2011-07-11
- Stop
- 2011-07-11
The parties
- Patient
- patient Emile Lawerence Lesch
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
2fda87fd-29fd-b4f1-dda8-cdd225d7309d