Claim total
$196.20
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2024-10-31
- Stop
- 2024-10-31
The parties
- Patient
- patient Britany Kerrie West
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
02a95708-afbd-de6b-22fa-6876fd7d27c7