Claim total
$504.69
base $93.39 · payer covered $302.81
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2010-05-06
- Stop
- 2010-05-06
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-7111-845cba32ad0e