Claim total
$323.91
base $93.39 · payer covered $273.91
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2017-02-08
- Stop
- 2017-02-08
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-1d89-a3e7ddbe1d46