Claim total
$504.69
base $93.39 · payer covered $469.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2009-02-24
- Stop
- 2009-02-24
The parties
- Patient
- patient Lupe Lorenzo Brekke
- Provider
- provider Hassie Beer
- Payer
- payer Dual Eligible
Record id
1816a270-2239-ee33-6418-0059395df880