Claim total
$114.34
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2026-01-22
- Stop
- 2026-01-22
The parties
- Patient
- patient Britany Kerrie West
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
02a95708-afbd-de6b-fe6f-6b99777924fb