Claim total
$100.74
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2024-04-15
- Stop
- 2024-04-15
The parties
- Patient
- patient Otha Jewel Ankunding
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
Record id
01bd7d75-9405-280a-f8b5-2cb2bc56121a