Claim total
$94.57
base $93.39 · payer covered $44.57
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1973-02-23
- Stop
- 1973-02-23
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Hassie Beer
- Payer
- payer Medicaid
Record id
028512d5-49bb-87e7-f68a-595c27aab823