Claim total
$118.35
base $93.39 · payer covered $68.35
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2020-02-15
- Stop
- 2020-02-15
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Odessa Schamberger
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-4d77-1d30256fb567