Claim total
$504.69
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1987-02-11
- Stop
- 1987-02-11
The parties
- Patient
- patient Leonor Raina Watsica
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
2e0dfd0f-820d-64e7-48cc-318050d427e3