Claim total
$173.22
base $93.39 · payer covered $121.25
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2020-06-08
- Stop
- 2020-06-08
The parties
- Patient
- patient Onie Shannon Borer
- Provider
- provider Avery VonRueden
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Cigna Health
Record id
006af299-d813-2b4f-2151-799c719bf1dd