Claim total
$230.43
base $93.39 · payer covered $180.43
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2020-02-18
- Stop
- 2020-02-18
The parties
- Patient
- patient Cristobal Dana Wolf
- Provider
- provider Carmine Carter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
016cc0d6-9a88-e8dc-106c-1dfc4d9a6dcf