Claim total
$7,246.04
base $155.66 · payer covered $7,196.04
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-03-04
- Stop
- 2017-03-04
The parties
- Patient
- patient Cecilia Botsford
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
046c8377-6cc1-c8f9-c9b6-8b1dc24cdbfe