Claim total
$104.84
base $93.39 · payer covered $54.84
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1988-02-24
- Stop
- 1988-02-24
The parties
- Patient
- patient Soledad Rocio Aguirre
- Provider
- provider Artie Schultz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
060aa7a8-9653-5ae4-d73f-a253bb16469b