Claim total
$168.50
base $93.39 · payer covered $117.95
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1996-04-12
- Stop
- 1996-04-12
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Antonietta Purdy
Record id
062f00f9-5db0-55c4-fcd0-d7f6741be35b