Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2024-08-26
- Stop
- 2024-08-26
The parties
- Patient
- patient Ben Ernesto Rosenbaum
- Provider
- provider Ken Hane
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
24f70975-753d-446a-158b-42b8c171cd5d