Claim total
$5,038.15
base $155.66 · payer covered $3,022.89
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2025-11-13
- Stop
- 2025-11-13
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-806f-bd3c07eb77f9