Claim total
$617.66
base $93.39 · payer covered $567.66
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2015-06-10
- Stop
- 2015-06-10
The parties
- Patient
- patient Miles Auer
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
02b37b89-9593-6a10-b143-ed8554fa8b65