Claim total
$363.40
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2019-05-28
- Stop
- 2019-05-28
The parties
- Patient
- patient Cyndi Tromp
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
01936333-6290-e7a2-7374-9bb580e8dcd5