Claim total
$116.72
base $93.39 · payer covered $116.72
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1995-08-17
- Stop
- 1995-08-17
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
03563bad-3832-f030-ca78-a942dc45cf7d