Claim total
$590.00
base $93.39 · payer covered $540.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1994-03-09
- Stop
- 1994-03-09
The parties
- Patient
- patient Soledad Rocio Aguirre
- Provider
- provider Laurence Mosciski
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
060aa7a8-9653-5ae4-b28c-931e1077fd0c