Claim total
$176.99
base $93.39 · payer covered $126.99
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2025-07-30
- Stop
- 2025-07-30
The parties
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-1f47-e7a8d8367100