Claim total
$611.88
base $93.39 · payer covered $561.88
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2025-09-22
- Stop
- 2025-09-22
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Hassie Beer
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-46a8-00706eac2d32