Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-14
- Stop
- 2021-04-14
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-7f9a-72427da50f48