Claim total
$978.26
base $155.66 · payer covered $928.26
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2021-09-25
- Stop
- 2021-09-25
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Clint Witting
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-fe08-063397d1b54c