Claim total
$111.69
base $93.39 · payer covered $61.69
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2019-02-02
- Stop
- 2019-02-02
The parties
- Patient
- patient Gita Pei Mraz
- Provider
- provider Mitch Murazik
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
01d312ef-e970-710c-8677-6eed07ce1c3c