Claim total
$5,596.41
base $155.66 · payer covered $5,596.41
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 1992-05-07
- Stop
- 1992-05-07
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0095f26f-6c35-6a9c-6691-62c6c34d7499