Claim total
$130.56
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2021-03-09
- Stop
- 2021-03-09
The parties
- Patient
- patient Janie Ranae Botsford
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
041efb3a-8e81-3ea8-8133-b48038a94006