Claim total
$566.96
base $155.66 · payer covered $267.17
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2021-12-13
- Stop
- 2021-12-13
The parties
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
2c220e10-502c-5092-5f0a-844b7d4c336c