Claim total
$566.96
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2020-10-09
- Stop
- 2020-10-09
The parties
- Patient
- patient Maurice Lazaro Quitzon
- Provider
- provider María Soledad Archuleta
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Humana
Record id
341fd27b-4f29-bb85-ee82-9b6b718f1378