Claim total
$117.46
base $93.39 · payer covered $67.46
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2017-10-13
- Stop
- 2017-10-13
The parties
- Patient
- patient Carmel Candace Corwin
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
05f2be84-5448-13b2-dc3b-6fb6c57bfa4e