Claim total
$131.83
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2023-11-24
- Stop
- 2023-11-24
The parties
- Patient
- patient Marilynn Jaimie Pouros
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
0126af27-a469-d3f6-19d4-acdf412f2038