Claim total
$12,803.39
base $155.66 · payer covered $12,768.39
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2024-02-23
- Stop
- 2024-02-23
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-c297-9689c9cb4cbc