Claim total
$268.72
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2025-07-09
- Stop
- 2025-07-09
The parties
- Patient
- patient Jefferson Fredrick Stamm
- Provider
- provider Amber Yost
- Payer
- payer Humana
Record id
02e8a145-6422-3c9c-4c9b-54d7a892739f