Claim total
$566.96
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2013-02-07
- Stop
- 2013-02-07
The parties
- Patient
- patient Del Lueilwitz
- Provider
- provider Maryam Wolf
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Anthem
Record id
1591acd8-0c3e-6a58-fb1f-03b1a5d59848