Claim total
$11,725.29
base $155.66 · payer covered $3,378.77
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2023-11-09
- Stop
- 2023-11-09
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Rebeca Lomeli
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-2435-73682625023b