Claim total
$1,322.44
base $93.39 · payer covered $1,272.44
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute viral pharyngitis195662009
- Start
- 2021-05-14
- Stop
- 2021-05-14
The parties
- Patient
- patient Gita Pei Mraz
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
01d312ef-e970-710c-f0b1-07a7067ba3b6