Claim total
$278.17
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2003-08-02
- Stop
- 2003-08-02
The parties
- Patient
- patient Jarred Leon Volkman
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
04a55b5e-c1dc-db1f-9891-c3f20deed4c0