Claim total
$273.66
base $93.39 · payer covered $223.66
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2018-03-27
- Stop
- 2018-03-27
The parties
- Patient
- patient Nicky Kristi Wiegand
- Provider
- provider Cory Lynch
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
0358d022-e88b-b208-6c02-7d845f948128