Claim total
$147.03
base $93.39 · payer covered $97.03
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2020-04-26
- Stop
- 2020-04-26
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Amber Yost
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-c96c-f7242e3d714e