Claim total
$101.54
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2025-04-09
- Stop
- 2025-04-10
The parties
- Patient
- patient Carolee Shenna Franecki
- Provider
- provider Heriberto Smitham
Record id
05da998f-3dd0-aeca-9bf3-5f773d6f9e83