Claim total
$209.41
base $93.39 · payer covered $146.58
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2019-11-29
- Stop
- 2019-11-29
The parties
- Patient
- patient Josh Monahan
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Cigna Health
Record id
03f57d95-a536-8def-5946-0ef82647b71a