Claim total
$987.58
base $93.39 · payer covered $691.30
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2025-11-28
- Stop
- 2025-11-28
The parties
- Patient
- patient Wilbur McCullough
- Provider
- provider Whitney Homenick
- Care site
- care site NORTH MEMORIAL HEALTH CARE
Record id
0418f551-ced3-e811-a06b-05afdbfea16b