Claim total
$18,835.98
base $155.66 · payer covered $18,785.98
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-01-16
- Stop
- 2017-01-16
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-a375-9f423502651c