Claim total
$491.95
base $93.39 · payer covered $441.95
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2023-02-25
- Stop
- 2023-02-25
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-b596-d1eefb41dca3