Claim total
$95.21
base $93.39 · payer covered $45.21
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2020-03-17
- Stop
- 2020-03-17
The parties
- Patient
- patient Louella Roberts
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
05092f50-4c35-2d72-70b5-76bebc90ca52