Claim total
$93.65
base $93.39 · payer covered $43.65
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2026-09-13
- Stop
- 2026-09-13
The parties
- Patient
- patient Adrian Grady O'Keefe
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
00a9bdc8-6b4d-5df7-1d67-279b55d088f2