Claim total
$5,038.15
base $155.66 · payer covered $4,888.15
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 1993-12-23
- Stop
- 1993-12-23
The parties
- Patient
- patient Soledad Rocio Aguirre
- Provider
- provider Eddy Cassin
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
060aa7a8-9653-5ae4-e238-5710eeab7f3e