Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2017-01-04
- Stop
- 2017-01-04
The parties
- Patient
- patient Jamey Korey Ullrich
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
18208ada-8c38-708d-fbba-9f002dce8326