Claim total
$14,870.26
base $155.66 · payer covered $14,820.26
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2018-04-06
- Stop
- 2018-04-06
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-dcff-e205b6bca8bf