Claim total
$111.53
base $93.39 · payer covered $61.53
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2017-03-15
- Stop
- 2017-03-15
The parties
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-fbef-dd7c6817131d