Claim total
$105.29
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1995-12-15
- Stop
- 1995-12-15
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Amber Yost
- Payer
- payer No insurance
Record id
00cb11fd-f3f7-0950-5241-aa3593a69c14