Claim total
$211.37
base $93.39 · payer covered $161.37
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2026-07-26
- Stop
- 2026-07-26
The parties
- Patient
- patient Terrance Raymon Kuhic
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
03e733d5-721a-3740-d159-a58e6529880f