Claim total
$657.59
base $93.39 · payer covered $526.07
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2017-02-09
- Stop
- 2017-02-09
The parties
- Patient
- patient Alison Ashlea Frami
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Anthem
Record id
023818a4-3852-fbab-a123-a5c8c1654c9e