Claim total
$566.96
base $155.66 · payer covered $453.57
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2017-09-23
- Stop
- 2017-09-23
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
056f2732-3438-a432-2ade-3def54c504cb