Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Glycine max256355007
- Start
- 2012-10-08
- Stop
- 2012-10-08
The parties
- Patient
- patient Jo Stark
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
1d1bc9fc-5beb-0b04-c938-02ac217d94f8