Claim total
$207.21
base $93.39 · payer covered $207.21
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2016-11-23
- Stop
- 2016-11-23
The parties
- Patient
- patient Christel Torp
- Provider
- provider Heriberto Smitham
Record id
00edd987-99b7-13d9-5fca-449f8026879a