Claim total
$444.55
base $93.39 · payer covered $394.55
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2011-07-14
- Stop
- 2011-07-15
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-6892-6eac882c1561