Claim total
$249.81
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2016-08-02
- Stop
- 2016-08-02
The parties
- Patient
- patient Eulah Avril Aufderhar
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
02aef5a1-9ba3-229b-76af-b95095b841b0