Claim total
$117.34
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2018-06-25
- Stop
- 2018-06-25
The parties
- Patient
- patient Augustus Rich Stark
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
0239a00d-0894-874c-2cfb-22f4a1ee28f2