Claim total
$6,239.84
base $155.66 · payer covered $6,239.84
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-01-05
- Stop
- 2017-01-05
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Pasquale Grimes
Record id
00cb11fd-f3f7-0950-e987-383ab78a1d63