Claim total
$156.61
base $93.39 · payer covered $106.61
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2023-05-13
- Stop
- 2023-05-13
The parties
- Patient
- patient Shalon Arnetta Bosco
- Provider
- provider Kristeen Metz
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03f768f4-038d-f7fd-3bb7-07b02f3355fb