Claim total
$284.22
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2017-07-30
- Stop
- 2017-07-30
The parties
- Patient
- patient Denyse Fadel
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Anthem
Record id
048ae427-86b6-6ce9-83e0-c3e44f122e97