Claim total
$216.26
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2019-09-14
- Stop
- 2019-09-14
The parties
- Patient
- patient Reatha Victor O'Conner
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Aetna
Record id
0521a0be-ba7b-b4e6-eea8-7911c6f86bb9