Claim total
$14,128.30
base $155.66 · payer covered $14,093.30
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2024-12-14
- Stop
- 2024-12-14
The parties
- Patient
- patient Ramona Schinner
- Provider
- provider Dale Mertz
- Payer
- payer Dual Eligible
Record id
032000cf-30b4-7e9b-a2a5-46cde8b2a525