Claim total
$275.38
base $93.39 · payer covered $225.38
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2006-12-30
- Stop
- 2006-12-30
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Pinkie Parisian
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
01bbe7d1-151b-3eec-b064-0ccb330bcedb