Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2015-06-30
- Stop
- 2015-06-30
The parties
- Patient
- patient Raul Dooley
- Provider
- provider Hassie Beer
- Payer
- payer Medicaid
Record id
2dcc7333-1d20-9674-7636-227e59c329f6