Claim total
$12,522.22
base $155.66 · payer covered $12,472.22
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2018-07-28
- Stop
- 2018-07-28
The parties
- Patient
- patient Cecilia Botsford
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
046c8377-6cc1-c8f9-8960-7b6312e95095