Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1999-09-14
- Stop
- 1999-09-14
The parties
- Patient
- patient Charlott Yi Walter
- Provider
- provider Pasquale Grimes
- Payer
- payer Medicaid
Record id
1508a0e5-67d3-1dfd-cd2f-47366d704886