Claim total
$129.41
base $93.39 · payer covered $79.41
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2017-07-31
- Stop
- 2017-07-31
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Janette Fisher
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-794d-1b878ff2aa3e