Claim total
$242.16
base $93.39 · payer covered $192.16
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2018-01-25
- Stop
- 2018-01-25
The parties
- Patient
- patient Daron Cormier
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
061edbc8-fb70-a6fd-58fa-d411b4e578f8