Claim total
$10,746.79
base $155.66 · payer covered $10,696.79
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2019-12-15
- Stop
- 2019-12-15
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-3b7d-73823a9a22f1