Claim total
$203.08
base $93.39 · payer covered $162.46
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2016-12-08
- Stop
- 2016-12-08
The parties
- Patient
- patient Simon Frederic Gulgowski
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
034c4f48-8c73-4f35-2c96-34bfdc26c7b3