Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Outpatient
- Code
- 185345009
- Reason
- diagnosis concept Otitis media65363002
- Start
- 2026-04-04
- Stop
- 2026-04-04
The parties
- Patient
- patient Demetrius Fabian Fahey
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
011d229d-4683-9f9e-98a5-a6ad4126b42e