Claim total
$123.90
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2018-08-02
- Stop
- 2018-08-02
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
03563bad-3832-f030-e07e-7355cb758930