Claim total
$158.29
base $93.39 · payer covered $108.29
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1953-04-10
- Stop
- 1953-04-10
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
028512d5-49bb-87e7-b669-4df67ea857e5