Claim total
$132.58
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2002-12-07
- Stop
- 2002-12-07
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Pa Kulas
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer No insurance
Record id
01bbe7d1-151b-3eec-36aa-9314a8915182