Claim total
$287.33
base $93.39 · payer covered $237.33
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 1956-01-20
- Stop
- 1956-01-20
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
028512d5-49bb-87e7-bb7e-b5ea4cd75262