Claim total
$192.64
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2010-05-19
- Stop
- 2010-05-19
The parties
- Patient
- patient Felipe Dwain Keebler
- Provider
- provider Amber Yost
- Payer
- payer Humana
Record id
02f04cf4-122a-e8d3-0d3c-6dc96fb864c7