Claim total
$98.25
base $93.39 · payer covered $48.25
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2007-04-14
- Stop
- 2007-04-14
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Pa Kulas
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
01bbe7d1-151b-3eec-8412-5510ce2b2ffa