Claim total
$253.14
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2004-05-05
- Stop
- 2004-05-05
The parties
- Patient
- patient Felipe Dwain Keebler
- Provider
- provider Amber Yost
- Payer
- payer Humana
Record id
02f04cf4-122a-e8d3-0990-935750f8e8a5