Claim total
$576.15
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2020-05-28
- Stop
- 2020-05-28
The parties
- Patient
- patient Britany Kerrie West
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
02a95708-afbd-de6b-dbad-a86948d8fb63