Allergic disorder initial assessment

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patient Clemmie Evangeline Paucek
Allergic disorder initial assessment

Claim total

$566.96

base $155.66 · payer covered $0.00

The visit

Class: Ambulatory
Code: 170837001
Reason: Allergic disposition609328004
Start: 2020-02-20
Stop: 2020-02-20

The parties

Patient: patient Clemmie Evangeline Paucek
Provider: provider Dale Mertz
Care site: care site HENNEPIN COUNTY MEDICAL CENTER 1
Payer: payer UnitedHealthcare

Record id 19b87c0d-b841-18cf-5f0a-9d7e9816eb8e