Claim total
$363.93
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2017-07-27
- Stop
- 2017-07-27
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
03563bad-3832-f030-625f-85a5d6bc3ddd