Claim total
$176.64
base $93.39 · payer covered $126.64
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2019-11-13
- Stop
- 2019-11-13
The parties
- Patient
- patient Cecilia Botsford
- Provider
- provider Mitch Murazik
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
046c8377-6cc1-c8f9-e865-dac0fa9fbe92