Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1973-06-22
- Stop
- 1973-06-22
The parties
- Patient
- patient Waltraud Tromp
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
1461ae1d-c357-fb97-4ae9-0182e5e2430c