Claim total
$245.82
base $93.39 · payer covered $195.82
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2026-05-28
- Stop
- 2026-05-28
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-83d7-47a4804ede06