Claim total
$118.78
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2003-08-18
- Stop
- 2003-08-18
The parties
- Patient
- patient Alyson Janie Marquardt
- Provider
- provider Carmine Carter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
00faac37-85e6-9663-ffa0-a18afab85d1f