Claim total
$504.69
base $93.39 · payer covered $504.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2011-07-26
- Stop
- 2011-07-26
The parties
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
12af21a2-f0a0-4eb0-ac26-646609a655be