Claim total
$200.15
base $93.39 · payer covered $150.15
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2008-05-09
- Stop
- 2008-05-09
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-54c7-a63460328cdb