Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2014-08-27
- Stop
- 2014-08-27
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-f971-120794b66c23