Claim total
$504.69
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2001-10-03
- Stop
- 2001-10-03
The parties
- Patient
- patient Humberto Hackett
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
28b97195-4a3c-8c0a-63d1-983edb6890c6