Claim total
$566.96
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2014-10-15
- Stop
- 2014-10-15
The parties
- Patient
- patient Erika Noriko Auer
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
Record id
0e32386c-c04d-ce35-9890-c79b6a9afb0c