Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Fracture subluxation of wrist263102004
- Start
- 2023-09-26
- Stop
- 2023-09-26
The parties
- Patient
- patient Shalon Arnetta Bosco
- Provider
- provider Pamula Dare
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03f768f4-038d-f7fd-cda3-c981c7445bee