Claim total
$95.71
base $93.39 · payer covered $45.71
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2018-08-01
- Stop
- 2018-08-01
The parties
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-b3fd-be44e230dad2