Claim total
$275.74
base $93.39 · payer covered $225.74
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2022-05-07
- Stop
- 2022-05-07
The parties
- Patient
- patient Shalon Arnetta Bosco
- Provider
- provider Al Considine
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03f768f4-038d-f7fd-d85b-4f8b5394eba0