Claim total
$566.96
base $155.66 · payer covered $453.57
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 1990-01-06
- Stop
- 1990-01-06
The parties
- Patient
- patient Gregg Thanh Casper
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
0f8a82e6-c6ea-0ec7-a2fe-7c80e83087db