Claim total
$157.92
base $93.39 · payer covered $107.92
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2026-04-01
- Stop
- 2026-04-01
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-d84f-ef3d533b2ad8