Claim total
$101.29
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1967-01-26
- Stop
- 1967-01-26
The parties
- Patient
- patient Emery Herbert Steuber
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
003012ce-f819-e17b-cd3d-e1aa6e7ea20e