Claim total
$93.57
base $93.39 · payer covered $43.57
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2024-06-27
- Stop
- 2024-06-27
The parties
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
04dc5210-87cc-ee45-00e9-f5ab0be8c9ea