Claim total
$10,713.00
base $155.66 · payer covered $10,713.00
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2026-03-08
- Stop
- 2026-03-08
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-dbed-2569f0fed6d6