Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1979-10-27
- Stop
- 1979-10-27
The parties
- Patient
- patient Benito Delao
- Provider
- provider Tiffany Smitham
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
30bb6e62-6649-f6c6-3ef0-032a71211e9c