Claim total
$1,217.82
base $93.39 · payer covered $1,182.82
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2012-07-23
- Stop
- 2012-07-23
The parties
- Patient
- patient Brendon Marcos Sanford
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
032ec4eb-84a5-3e3f-effb-ba8424708f89