Claim total
$15,219.25
base $155.66 · payer covered $15,169.25
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2018-03-10
- Stop
- 2018-03-10
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Burton O'Conner
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-9583-585019e385b2