Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2021-04-20
- Stop
- 2021-04-20
The parties
- Patient
- patient Cleo Timothy Kemmer
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
04d0e486-8d5f-7bad-f4bc-600d65471f43