Claim total
$8,516.69
base $155.66 · payer covered $8,481.69
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2022-07-23
- Stop
- 2022-07-23
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
04658673-6112-6940-2369-99af9674681f