Claim total
$107.48
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2020-04-25
- Stop
- 2020-04-25
The parties
- Patient
- patient Shalon Arnetta Bosco
- Provider
- provider Al Considine
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03f768f4-038d-f7fd-5f46-16588c8ae29e