Claim total
$978.26
base $155.66 · payer covered $928.26
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2017-04-08
- Stop
- 2017-04-08
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Grazyna Sauer
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-7c67-9dd2e2f6feb4