Claim total
$13,555.80
base $155.66 · payer covered $13,555.80
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2025-08-06
- Stop
- 2025-08-06
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-27c5-84f580f3dcb9