Claim total
$96.28
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2016-02-04
- Stop
- 2016-02-04
The parties
- Patient
- patient Alison Ashlea Frami
- Provider
- provider Michael Dibbert
- Payer
- payer Aetna
Record id
023818a4-3852-fbab-3f32-9fa12f17a989