Claim total
$6,617.17
base $155.66 · payer covered $6,567.17
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-03-22
- Stop
- 2017-03-22
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-7779-a45bfa24992a