Claim total
$504.69
base $93.39 · payer covered $403.75
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2012-06-04
- Stop
- 2012-06-04
The parties
- Patient
- patient Pok Shane Strosin
- Provider
- provider Irmgard Padberg
- Payer
- payer Anthem
Record id
00162663-d9d1-4955-5ab1-2048cc773796