Claim total
$459.24
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2025-11-21
- Stop
- 2025-11-21
The parties
- Patient
- patient Florinda Suzanna Lehner
- Provider
- provider Madalyn Konopelski
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
05d39322-006c-95d6-b133-4e4badbf0965