Claim total
$19,685.62
base $155.66 · payer covered $19,635.62
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2016-10-05
- Stop
- 2016-10-05
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
03e24eff-3793-eaeb-c318-409f4a91caca