Claim total
$93.63
base $93.39 · payer covered $43.63
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2025-05-31
- Stop
- 2025-05-31
The parties
- Patient
- patient Shalon Arnetta Bosco
- Provider
- provider Estelle Kling
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03f768f4-038d-f7fd-641c-fc79b16ad5e9