Claim total
$289.51
base $93.39 · payer covered $254.51
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2017-01-02
- Stop
- 2017-01-02
The parties
- Patient
- patient Brendon Marcos Sanford
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
032ec4eb-84a5-3e3f-146b-860e980c507b