Claim total
$755.85
base $93.39 · payer covered $705.85
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2024-12-29
- Stop
- 2024-12-29
The parties
- Patient
- patient Margo Green
- Provider
- provider Ian Ryan
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
029fe5e1-f60c-f237-3f80-543e5b894e75