Claim total
$122.98
base $93.39 · payer covered $72.98
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2022-02-05
- Stop
- 2022-02-05
The parties
- Provider
- provider Antonietta Purdy
- Payer
- payer Medicaid
Record id
03d1ce86-efe3-018d-6553-e14e4054de4f