Claim total
$364.34
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2001-11-03
- Stop
- 2001-11-03
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Noe Hills
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer No insurance
Record id
01bbe7d1-151b-3eec-8e95-b93a8cf9e0ea