Claim total
$94.00
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2025-02-02
- Stop
- 2025-02-02
The parties
- Patient
- patient Crista Karina Nienow
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Cigna Health
Record id
0266f4cc-2c2d-37bb-3871-8ed55cf70fac