Claim total
$117.67
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1999-01-27
- Stop
- 1999-01-27
The parties
- Patient
- patient Lincoln Reyes Hansen
- Provider
- provider Amber Yost
- Payer
- payer Humana
Record id
036e82a1-5d34-0b1d-caa6-49973c8a2f68