Claim total
$7,039.56
base $155.66 · payer covered $7,039.56
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2025-09-01
- Stop
- 2025-09-01
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-d917-9fa59a422896