Claim total
$94.94
base $93.39 · payer covered $44.94
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2024-02-10
- Stop
- 2024-02-10
The parties
- Provider
- provider Antonietta Purdy
- Payer
- payer Medicaid
Record id
03d1ce86-efe3-018d-8a06-02f19d9256ed