Claim total
$10,779.72
base $155.66 · payer covered $10,779.72
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-06-26
- Stop
- 2017-06-26
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Trinity Mraz
Record id
00cb11fd-f3f7-0950-173b-64afceae0de2