Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Fracture subluxation of wrist263102004
- Start
- 2022-07-29
- Stop
- 2022-07-29
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-d493-e3acda6c6e9d