Claim total
$113.87
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2018-09-19
- Stop
- 2018-09-19
The parties
- Patient
- patient Saul Little
- Provider
- provider Claudette Frami
- Care site
- care site Brooklyn Park Vet Center
- Payer
- payer Humana
Record id
0205c336-938f-d85a-1a2e-2d55df4006e2