Claim total
$146.68
base $93.39 · payer covered $111.68
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2014-04-24
- Stop
- 2014-04-24
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Zofia Bosco
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
01e64c71-bb1e-2212-f8c5-6542c879b4a2