Claim total
$169.00
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2022-07-18
- Stop
- 2022-07-18
The parties
- Patient
- patient Augustus Rich Stark
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
0239a00d-0894-874c-1758-846ee485c7e8