Claim total
$1,400.04
base $93.39 · payer covered $1,365.04
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2022-12-15
- Stop
- 2022-12-15
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-b892-16468ef5f02f