Claim total
$139.09
base $93.39 · payer covered $89.09
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1978-06-24
- Stop
- 1978-06-24
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-7d1b-14d48b43d9e9