Claim total
$105.52
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1981-10-08
- Stop
- 1981-10-08
The parties
- Patient
- patient Verona Ginger O'Keefe
- Provider
- provider Danilo Davis
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer No insurance
Record id
04161a30-0372-a815-8cf7-e122ffb550ec