Claim total
$189.73
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2020-10-08
- Stop
- 2020-10-08
The parties
- Patient
- patient Britany Kerrie West
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
02a95708-afbd-de6b-bb79-c257d0c43f6a