Claim total
$291.66
base $155.66 · payer covered $256.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-06-12
- Stop
- 2021-06-12
The parties
- Patient
- patient Barry Adam Heller
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
02680c28-26cc-4bca-bb07-ee2146363074