Claim total
$344.51
base $93.39 · payer covered $294.51
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2018-02-10
- Stop
- 2018-02-11
The parties
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
04424811-b26b-3a54-aeb5-614c6387e2fb