Claim total
$345.77
base $93.39 · payer covered $295.77
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2024-03-09
- Stop
- 2024-03-09
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-f70a-c8d22c9abf2d