Claim total
$113.73
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1988-12-18
- Stop
- 1988-12-18
The parties
- Patient
- patient Lesia Catalina Ledner
- Provider
- provider Jong King
- Care site
- care site MERCY HOSPITAL
- Payer
- payer No insurance
Record id
058279b6-7701-4823-25c4-62237648cb90