Claim total
$127.08
base $93.39 · payer covered $77.08
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2007-02-17
- Stop
- 2007-02-17
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Martina Heidenreich
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
01bbe7d1-151b-3eec-f4f0-6f0a69d5e543