Claim total
$153.61
base $93.39 · payer covered $103.61
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2025-05-03
- Stop
- 2025-05-03
The parties
- Patient
- patient Alvin Tracy Morar
- Provider
- provider Carmine Carter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
00df058f-9df4-4d69-4e67-e0c8165bf0b9