Claim total
$6,530.03
base $155.66 · payer covered $6,530.03
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2016-11-15
- Stop
- 2016-11-15
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Trinity Mraz
Record id
00cb11fd-f3f7-0950-4314-e21b5414600b