Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Start
- 2025-09-04
- Stop
- 2025-09-04
The parties
- Patient
- patient Alva Randy Gislason
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
06b076c2-4241-661b-9603-b5817f7bb7e5