Claim total
$411.82
base $93.39 · payer covered $361.82
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2020-02-17
- Stop
- 2020-02-17
The parties
- Patient
- patient Elliot Blaine Buckridge
- Provider
- provider Carmine Carter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
00a5a31e-a2f8-175f-c983-fb2191260a64