Claim total
$99.94
base $93.39 · payer covered $49.94
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1977-03-19
- Stop
- 1977-03-19
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-9b2f-0149aab05a89