Claim total
$110.07
base $93.39 · payer covered $60.07
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1983-05-11
- Stop
- 1983-05-11
The parties
- Patient
- patient Susanna Avis Emard
- Provider
- provider Hassie Beer
- Payer
- payer Medicaid
Record id
0443166c-c803-503e-adff-73a2e1fdcd65