Claim total
$566.96
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2025-12-05
- Stop
- 2025-12-05
The parties
- Patient
- patient Bart Chase Thiel
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer UnitedHealthcare
Record id
104eb795-e5b0-8afd-d753-d98bb270b5b1