Claim total
$95.51
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2018-06-13
- Stop
- 2018-06-13
The parties
- Patient
- patient Carolee Shenna Franecki
- Provider
- provider Heriberto Smitham
Record id
05da998f-3dd0-aeca-af34-66456df26c9c