Claim total
$229.96
base $93.39 · payer covered $179.96
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2021-12-12
- Stop
- 2021-12-12
The parties
- Patient
- patient Margo Green
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
029fe5e1-f60c-f237-61e4-61b9fa4cf16a