Claim total
$145.15
base $93.39 · payer covered $95.15
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2016-11-22
- Stop
- 2016-11-22
The parties
- Patient
- patient Matt Stanton Brown
- Provider
- provider Lyman Howell
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
04e52287-fbd6-ff57-f57d-c5a55a4e8f97