Claim total
$220.67
base $93.39 · payer covered $170.67
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1975-10-09
- Stop
- 1975-10-09
The parties
- Patient
- patient Santa Antonina Bernier
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
051f1153-ae45-1425-a48d-dace6a677e94