Claim total
$96.95
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2017-11-04
- Stop
- 2017-11-04
The parties
- Patient
- patient Terrell Doyle Heller
- Provider
- provider Carmine Carter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
0638f9ad-338f-7ad3-beb2-bbf5ddaedc8e