Claim total
$130.94
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2024-05-08
- Stop
- 2024-05-08
The parties
- Patient
- patient Christel Torp
- Provider
- provider Heriberto Smitham
Record id
00edd987-99b7-13d9-1a61-5d6d02f0cd4d