Claim total
$566.96
base $155.66 · payer covered $566.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2013-09-03
- Stop
- 2013-09-03
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Pasquale Grimes
Record id
00cb11fd-f3f7-0950-1c7c-dedc60a18db5