Claim total
$177.53
base $93.39 · payer covered $127.53
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2022-02-26
- Stop
- 2022-02-26
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Ken Hane
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-a08d-008c13b0f7db