Claim total
$15,711.42
base $155.66 · payer covered $9,426.86
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2023-12-14
- Stop
- 2023-12-15
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-c549-c41347d4506f