Claim total
$5,430.00
base $155.66 · payer covered $5,395.00
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2024-01-30
- Stop
- 2024-01-30
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
04658673-6112-6940-7644-b34f6c730296