Claim total
$129.74
base $93.39 · payer covered $79.74
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2023-08-08
- Stop
- 2023-08-08
The parties
- Patient
- patient Annamarie Mollie Hoppe
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
0555f11c-c453-57eb-9b5c-df077dc16095