Claim total
$93.64
base $93.39 · payer covered $43.64
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2022-11-22
- Stop
- 2022-11-22
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-bf0c-1eab52a86c9d