Claim total
$355.05
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2002-05-24
- Stop
- 2002-05-24
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Antonietta Purdy
Record id
062f00f9-5db0-55c4-61a4-003e5b5e81fd