Claim total
$122.81
base $93.39 · payer covered $72.81
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2018-01-06
- Stop
- 2018-01-06
The parties
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03d1ce86-efe3-018d-f58c-97b74296dda2