Claim total
$111.52
base $93.39 · payer covered $61.52
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2023-02-18
- Stop
- 2023-02-18
The parties
- Patient
- patient Tyrone Gerry Nolan
- Provider
- provider Alesia Douglas
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
0372df5d-1b51-df61-2484-150a174d5c67