Claim total
$1,025.17
base $93.39 · payer covered $820.13
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1984-04-19
- Stop
- 1984-04-19
The parties
- Patient
- patient Simon Frederic Gulgowski
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer UnitedHealthcare
Record id
034c4f48-8c73-4f35-34d8-d6992da8b405