Claim total
$138.05
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2018-11-21
- Stop
- 2018-11-21
The parties
- Patient
- patient Nona Samara Gleichner
- Provider
- provider Amber Yost
- Payer
- payer Humana
Record id
0042ca65-dd9d-7221-6260-ad9d1513f4be