Claim total
$163.10
base $93.39 · payer covered $114.17
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2017-09-13
- Stop
- 2017-09-13
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
0291d14d-46f7-a76b-9836-9431fcc8f30e