Claim total
$423.34
base $93.39 · payer covered $373.34
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2021-06-26
- Stop
- 2021-06-26
The parties
- Patient
- patient Tyrone Gerry Nolan
- Provider
- provider Stephaine O'Keefe
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
0372df5d-1b51-df61-d7d0-95fd46ef5d2d