Claim total
$112.85
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1971-10-12
- Stop
- 1971-10-12
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Jong King
- Care site
- care site MERCY HOSPITAL
- Payer
- payer No insurance
Record id
047ee4ec-c50b-b504-91c2-d79c7a80cd3f