Claim total
$340.93
base $93.39 · payer covered $290.93
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2023-04-14
- Stop
- 2023-04-14
The parties
- Patient
- patient Wilson Teodoro Kihn
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
04540647-5ff4-de4a-4741-b3ea27af83a6