Claim total
$474.07
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2025-06-26
- Stop
- 2025-06-26
The parties
- Patient
- patient Michal Andrew Champlin
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
01866125-a841-a217-8898-690ff7058b2a