Claim total
$252.78
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2012-07-11
- Stop
- 2012-07-11
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
0291d14d-46f7-a76b-7c62-2bcd848ce944