Claim total
$290.31
base $93.39 · payer covered $240.31
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2017-06-08
- Stop
- 2017-06-08
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Ines Kautzer
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-7bfd-63a3e45a74d2