Claim total
$94.26
base $93.39 · payer covered $44.26
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2013-04-16
- Stop
- 2013-04-16
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Artie Schultz
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-1fb8-bc1af8ce5504