Claim total
$98.26
base $93.39 · payer covered $48.26
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2018-03-13
- Stop
- 2018-03-13
The parties
- Patient
- patient Louella Roberts
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
05092f50-4c35-2d72-65eb-22dfc7f16327