Claim total
$566.96
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2022-12-02
- Stop
- 2022-12-02
The parties
- Patient
- patient Lanita Daysi Jast
- Provider
- provider Jo Stiedemann
- Payer
- payer Anthem
Record id
220bdd53-c919-6b71-baed-d16b400b0ca1