Claim total
$504.69
base $93.39 · payer covered $302.81
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1998-08-04
- Stop
- 1998-08-04
The parties
- Patient
- patient Jeramy Diego Keebler
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
024ea619-fff0-c0e8-aca6-21f0dae610bd