Claim total
$292.22
base $93.39 · payer covered $242.22
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2018-08-06
- Stop
- 2018-08-06
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-6fba-10d60a6f57b7