Claim total
$779.71
base $93.39 · payer covered $729.71
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1994-07-21
- Stop
- 1994-07-21
The parties
- Patient
- patient Lynda Carissa Wiza
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
11b58047-9562-e585-9635-babc6e42f316