Claim total
$108.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2024-02-04
- Stop
- 2024-02-05
The parties
- Patient
- patient Heriberto Bennie Walsh
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
02b5c001-4bdb-16d2-bdbd-3463499d0cec