Claim total
$94.41
base $93.39 · payer covered $44.41
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2025-04-25
- Stop
- 2025-04-25
The parties
- Patient
- patient Wilson Teodoro Kihn
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
04540647-5ff4-de4a-c0cb-1b0797a49bdf