Claim total
$162.25
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2001-06-28
- Stop
- 2001-06-28
The parties
- Patient
- patient Angelo Muller
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
036bf274-5bd6-d003-7e8d-6116226028ab