Claim total
$106.92
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2018-06-12
- Stop
- 2018-06-12
The parties
- Patient
- patient Caitlyn Elli Kuhlman
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
0037332a-29d1-a298-1a05-6e609940b8a3