Claim total
$326.91
base $93.39 · payer covered $276.91
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1976-04-28
- Stop
- 1976-04-29
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-7546-67705cfade2b