Claim total
$227.72
base $93.39 · payer covered $227.72
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2008-01-05
- Stop
- 2008-01-05
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Dorethea Predovic
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Humana
Record id
01bbe7d1-151b-3eec-0e45-fa8b135ba4a4