Claim total
$180.63
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2015-11-19
- Stop
- 2015-11-19
The parties
- Patient
- patient Son Lesley Hauck
- Provider
- provider Antonetta Lubowitz
- Payer
- payer No insurance
Record id
01d28099-b492-968b-466e-c7ffef670619