Claim total
$394.89
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2018-08-07
- Stop
- 2018-08-07
The parties
- Patient
- patient Eulah Avril Aufderhar
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
02aef5a1-9ba3-229b-5d81-6ad26423a766