Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Outpatient
- Code
- 185345009
- Reason
- diagnosis concept Otitis media65363002
- Start
- 2025-07-20
- Stop
- 2025-07-20
The parties
- Patient
- patient Marsha Dodie Kuvalis
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
062d51e6-50d3-3fdf-dc24-419f4e6c7af1