Claim total
$94.99
base $93.39 · payer covered $44.99
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2020-06-25
- Stop
- 2020-06-25
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Garret Mohr
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-3ffc-ab54f256ca13