Claim total
$129.34
base $93.39 · payer covered $79.34
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2019-12-18
- Stop
- 2019-12-18
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Ken Hane
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-b777-4212130fb845