Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1980-05-18
- Stop
- 1980-05-18
The parties
- Patient
- patient Shannon Dietrich
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
38564dd1-5505-1cf8-1d91-f91beeee0352