Claim total
$523.79
base $93.39 · payer covered $473.79
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2024-09-16
- Stop
- 2024-09-16
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Hassie Beer
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-51d9-03960b41ae7f