Claim total
$163.15
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2023-08-16
- Stop
- 2023-08-16
The parties
- Patient
- patient Anderson Randell Stracke
- Provider
- provider Madalyn Konopelski
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Cigna Health
Record id
0205f653-6551-192d-d3a9-0ff21690a511