Claim total
$258.52
base $93.39 · payer covered $208.52
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2020-02-08
- Stop
- 2020-02-08
The parties
- Patient
- patient Bernard Gleichner
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
04317637-3b9f-f5e4-c1d0-05c968f1de9b