Claim total
$222.11
base $93.39 · payer covered $172.11
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2017-01-28
- Stop
- 2017-01-28
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Odessa Schamberger
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-8ad4-5fc7285540c6