Claim total
$148.54
base $93.39 · payer covered $98.54
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1995-08-17
- Stop
- 1995-08-17
The parties
- Patient
- patient Alison Ashlea Frami
- Provider
- provider Janette Fisher
- Payer
- payer Medicaid
Record id
023818a4-3852-fbab-4f8d-050f502c7aa2