Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2013-08-03
- Stop
- 2013-08-03
The parties
- Patient
- patient Stuart Bennie Torp
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
12b83633-7c2e-6812-c9b4-b0eedd43420b