Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Glycine max256355007
- Start
- 1964-04-29
- Stop
- 1964-04-29
The parties
- Patient
- patient Elisha Duncan Hartmann
- Provider
- provider Rebeca Lomeli
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
0e205e2d-543b-28ab-9a25-9bbf129e5222