Claim total
$9,268.18
base $155.66 · payer covered $9,268.18
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2024-04-02
- Stop
- 2024-04-02
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-e0b3-e3e69882ef8d