Claim total
$2,800.51
base $93.39 · payer covered $2,750.51
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2025-10-27
- Stop
- 2025-10-27
The parties
- Patient
- patient Brendon Marcos Sanford
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
032ec4eb-84a5-3e3f-9e5c-68072a1aee5d