Claim total
$1,170.05
base $93.39 · payer covered $1,120.05
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1975-11-09
- Stop
- 1975-11-09
The parties
- Patient
- patient Lesia Catalina Ledner
- Provider
- provider Grazyna Sauer
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
058279b6-7701-4823-2713-4dfff69462f4