Claim total
$978.26
base $155.66 · payer covered $978.26
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2018-11-02
- Stop
- 2018-11-02
The parties
- Patient
- patient Cristina Caridad Salcedo
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
031e24ca-9978-b353-747f-a8371114c3a5