Claim total
$193.68
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2021-06-06
- Stop
- 2021-06-06
The parties
- Patient
- patient Heriberto Bennie Walsh
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
02b5c001-4bdb-16d2-45a2-b173398488a9