Claim total
$175.91
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2021-01-22
- Stop
- 2021-01-22
The parties
- Patient
- patient Nikole Ronald Crona
- Provider
- provider Jong King
- Care site
- care site MERCY HOSPITAL
- Payer
- payer No insurance
Record id
0205d624-3e5e-6b66-bc87-014bb9514cf9