Claim total
$175.89
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2001-08-30
- Stop
- 2001-08-30
The parties
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
0366d403-b006-0b76-4880-c4990ea561de