Claim total
$188.80
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2018-11-22
- Stop
- 2018-11-22
The parties
- Patient
- patient Son Lesley Hauck
- Provider
- provider Antonetta Lubowitz
- Payer
- payer No insurance
Record id
01d28099-b492-968b-e954-ef683212438c