Claim total
$95.08
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1996-09-05
- Stop
- 1996-09-05
The parties
- Patient
- patient Allen Trent Mann
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
007bcc47-8ca5-7eab-7ae6-28757f3ce20d