Claim total
$309.92
base $93.39 · payer covered $259.92
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2014-05-31
- Stop
- 2014-05-31
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Mary Harvey
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-ca95-94db7e64c246