Claim total
$504.69
base $93.39 · payer covered $504.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2013-09-03
- Stop
- 2013-09-03
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Trinity Mraz
Record id
00cb11fd-f3f7-0950-6464-8f376c56af67