Claim total
$238.45
base $93.39 · payer covered $188.45
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2020-09-19
- Stop
- 2020-09-19
The parties
- Patient
- patient Bernard Gleichner
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
04317637-3b9f-f5e4-d808-dbc048e3a834