Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Ambulatory
- Code
- 170838006
- Reason
- Allergic disposition609328004
- Start
- 1994-01-18
- Stop
- 1994-01-18
The parties
- Patient
- patient Soledad Rocio Aguirre
- Provider
- provider Artie Schultz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
060aa7a8-9653-5ae4-f4d0-86bf86c84b0e