Claim total
$384.19
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2020-03-28
- Stop
- 2020-03-28
The parties
- Patient
- patient Berry Aaron Deckow
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
03959b6c-660d-eecd-26f3-938f8f1ff253