Claim total
$19,685.62
base $155.66 · payer covered $19,685.62
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2024-10-15
- Stop
- 2024-10-15
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-f8f1-49f8e56f1a8d