Claim total
$566.96
base $155.66 · payer covered $267.17
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2014-08-01
- Stop
- 2014-08-01
The parties
- Patient
- patient Clarence Curtis Johnson
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
18a704fb-0dc4-6adf-ba10-43665ecd720a