Claim total
$118.71
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2017-06-19
- Stop
- 2017-06-19
The parties
- Patient
- patient Augustus Rich Stark
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
0239a00d-0894-874c-07ed-3967777b4c8d