Claim total
$104.62
base $93.39 · payer covered $54.62
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2022-04-13
- Stop
- 2022-04-13
The parties
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-5be1-d3d18faefb22