Claim total
$100.08
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1999-10-24
- Stop
- 1999-10-24
The parties
- Patient
- patient Leo Ramon Wolf
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
0132d8d5-6e6e-d90f-67cc-29d208d062ae