Claim total
$137.69
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2017-08-25
- Stop
- 2017-08-25
The parties
- Patient
- patient Florinda Suzanna Lehner
- Provider
- provider Julia Dueñas
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
05d39322-006c-95d6-5372-4d0ddb774dd7