Claim total
$11,134.00
base $155.66 · payer covered $11,084.00
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-01-31
- Stop
- 2017-01-31
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
03e24eff-3793-eaeb-481c-17b53470316b