Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-05-10
- Stop
- 2021-05-10
The parties
- Patient
- patient Augustus Rich Stark
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
0239a00d-0894-874c-9499-5d9b5b8cc193