Claim total
$5,183.41
base $155.66 · payer covered $5,148.41
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2023-06-27
- Stop
- 2023-06-27
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-e044-f2d256cc721c