Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Wheat412071004
- Start
- 1971-12-12
- Stop
- 1971-12-12
The parties
- Patient
- patient Rodolfo Cesar Cartwright
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
1c95d9b2-6189-e9d5-be7c-ecd6d6b28d6e