Claim total
$107.63
base $93.39 · payer covered $57.63
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1981-04-11
- Stop
- 1981-04-11
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-ecb4-c80bdc1f963a