Claim total
$566.96
base $155.66 · payer covered $453.57
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 1990-01-02
- Stop
- 1990-01-02
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0095f26f-6c35-6a9c-37a4-f230a059fdc6