Claim total
$171.91
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2014-07-29
- Stop
- 2014-07-29
The parties
- Patient
- patient Eulah Avril Aufderhar
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
02aef5a1-9ba3-229b-95d6-8c14fb718fd0