Claim total
$255.82
base $93.39 · payer covered $255.82
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2022-08-25
- Stop
- 2022-08-25
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
03563bad-3832-f030-9c2d-49fd33ee2197