Claim total
$586.51
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2021-03-31
- Stop
- 2021-04-01
The parties
- Patient
- patient Carolee Shenna Franecki
- Provider
- provider Heriberto Smitham
Record id
05da998f-3dd0-aeca-397d-3081b9d89fe0