Claim total
$5,038.15
base $155.66 · payer covered $5,003.15
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2023-09-05
- Stop
- 2023-09-05
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
04658673-6112-6940-a4f2-974a5d4d3a84