Claim total
$222.26
base $93.39 · payer covered $172.26
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2020-04-04
- Stop
- 2020-04-04
The parties
- Patient
- patient Alvin Tracy Morar
- Provider
- provider Carmine Carter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
00df058f-9df4-4d69-d340-bd3a919cd06e