Claim total
$97.38
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2023-08-31
- Stop
- 2023-08-31
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
03563bad-3832-f030-41f0-1d2f12fa73fd