Claim total
$126.88
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1936-12-15
- Stop
- 1936-12-15
The parties
- Patient
- patient Astrid Doria Dach
- Provider
- provider Hassie Beer
- Payer
- payer Humana
Record id
02e7d6ac-dd81-002b-98db-66f641189b8a