Claim total
$175.62
base $93.39 · payer covered $122.93
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2019-03-28
- Stop
- 2019-03-29
The parties
- Patient
- patient Emery Herbert Steuber
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
003012ce-f819-e17b-3faf-103de70a15f4