Claim total
$255.36
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2017-01-16
- Stop
- 2017-01-16
The parties
- Patient
- patient Aubrey Mattie Turcotte
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
01ad68d8-96ec-fcdf-80f0-c657d929106b