Claim total
$75.00
base $75.00 · payer covered $0.00
The visit
- Class
- Virtual
- Code
- 185347001
- Reason
- Peanut762952008
- Start
- 2022-04-06
- Stop
- 2022-04-06
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-aa81-423101a282bf