Claim total
$104.10
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2024-03-21
- Stop
- 2024-03-21
The parties
- Patient
- patient Alison Ashlea Frami
- Provider
- provider Michael Dibbert
- Payer
- payer Cigna Health
Record id
023818a4-3852-fbab-92d0-a650017fcc6d