Claim total
$978.26
base $155.66 · payer covered $928.26
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2024-05-11
- Stop
- 2024-05-11
The parties
- Patient
- patient Gita Pei Mraz
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
01d312ef-e970-710c-e312-8e48fab1a3b6