Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170838006
- Reason
- Allergic disposition609328004
- Start
- 2018-09-16
- Stop
- 2018-09-16
The parties
- Patient
- patient Cecilia Botsford
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
046c8377-6cc1-c8f9-2d95-7a2811f5b96a