Claim total
$358.93
base $93.39 · payer covered $308.93
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2005-06-08
- Stop
- 2005-06-08
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-4e2c-f640b3a8bd60