Claim total
$121.03
base $93.39 · payer covered $121.03
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1995-12-08
- Stop
- 1995-12-08
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Antonietta Purdy
Record id
062f00f9-5db0-55c4-a400-0b135cbeed79