Claim total
$199.88
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2001-07-13
- Stop
- 2001-07-13
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Amber Yost
- Payer
- payer No insurance
Record id
00cb11fd-f3f7-0950-69f7-9991920b1772