Claim total
$94.64
base $93.39 · payer covered $66.25
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1999-09-23
- Stop
- 1999-09-23
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
03563bad-3832-f030-914a-94fc2ca675fe