Claim total
$155.00
base $93.39 · payer covered $124.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2026-06-24
- Stop
- 2026-06-24
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Anthem
Record id
0190d3b1-c50c-bf7b-2dcb-ef04c9564bcd