Claim total
$128.87
base $93.39 · payer covered $103.09
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2024-07-31
- Stop
- 2024-07-31
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Anthem
Record id
0190d3b1-c50c-bf7b-be3c-870b3ddf75e8