Claim total
$978.26
base $155.66 · payer covered $928.26
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2023-05-17
- Stop
- 2023-05-17
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Ken Hane
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-c32e-6d46ee4f50e0