Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Eggs (edible)102263004
- Start
- 2005-08-24
- Stop
- 2005-08-24
The parties
- Patient
- patient Jimmy Leland Hermiston
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
34ccec67-7080-7434-deea-198d5e2681ec