Claim total
$93.66
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2012-01-26
- Stop
- 2012-01-26
The parties
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
0366d403-b006-0b76-b614-3826a304238d