Claim total
$272.39
base $93.39 · payer covered $222.39
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1972-06-17
- Stop
- 1972-06-17
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-0665-2e6942f12336