Claim total
$137.37
base $93.39 · payer covered $87.37
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2022-01-03
- Stop
- 2022-01-03
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-6520-052090e87d36