Claim total
$637.67
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2024-09-20
- Stop
- 2024-09-20
The parties
- Patient
- patient Florinda Suzanna Lehner
- Provider
- provider Tiffany Smitham
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
05d39322-006c-95d6-1685-768e436a0c10