Claim total
$377.68
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2004-10-04
- Stop
- 2004-10-04
The parties
- Patient
- patient Leif Darren West
- Provider
- provider Mitch Murazik
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer No insurance
Record id
04bc601b-5b17-3710-77db-6175bc9f4aee