Claim total
$102.61
base $93.39 · payer covered $52.61
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1995-11-04
- Stop
- 1995-11-04
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Zofia Bosco
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-8931-4ef68a0e38db