Claim total
$230.36
base $93.39 · payer covered $180.36
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2024-02-24
- Stop
- 2024-02-24
The parties
- Patient
- patient Tyrone Gerry Nolan
- Provider
- provider Alesia Douglas
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
0372df5d-1b51-df61-6f8a-2f9451589ff6