Claim total
$1,055.73
base $93.39 · payer covered $1,005.73
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1995-01-18
- Stop
- 1995-01-18
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Odessa Schamberger
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-5a41-098f5ba8d7ce