Claim total
$566.96
base $155.66 · payer covered $267.17
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2020-07-22
- Stop
- 2020-07-22
The parties
- Patient
- patient Latesha Olimpia Price
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
336a367a-9ecd-f668-8890-cee36ca64fa9