Claim total
$101.69
base $93.39 · payer covered $51.69
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2020-12-23
- Stop
- 2020-12-23
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Carmen Olson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-1230-90a5faf88097