Claim total
$134.96
base $93.39 · payer covered $84.96
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2025-07-24
- Stop
- 2025-07-24
The parties
- Patient
- patient Cathryn Kandy Smith
- Provider
- provider Kasi Schamberger
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
038ad96a-9908-2f0d-7356-4ebe93ed8181