Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2020-11-12
- Stop
- 2020-11-13
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Rebeca Lomeli
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-0613-50f6b1976b27