Claim total
$672.37
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2022-04-04
- Stop
- 2022-04-04
The parties
- Patient
- patient Otha Jewel Ankunding
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
Record id
01bd7d75-9405-280a-3c33-8446de7c7428