Claim total
$161.43
base $93.39 · payer covered $111.43
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2023-04-19
- Stop
- 2023-04-19
The parties
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-da9b-1d6b0a801499