Claim total
$12,179.46
base $155.66 · payer covered $12,179.46
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2025-05-21
- Stop
- 2025-05-21
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-5577-05089c79fa71