Claim total
$5,038.15
base $155.66 · payer covered $5,003.15
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2022-08-15
- Stop
- 2022-08-15
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
04658673-6112-6940-87a6-146f75aba7ed