Claim total
$116.43
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2026-05-16
- Stop
- 2026-05-16
The parties
- Patient
- patient Zachery Vincenzo Berge
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Cigna Health
Record id
01ce818c-8f9f-924a-07e8-d1f55e17b9e3