Claim total
$96.53
base $93.39 · payer covered $46.53
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2023-07-13
- Stop
- 2023-07-13
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Georgetta Kohler
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-11ec-e2d2541d5e45