Claim total
$106.56
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2004-06-04
- Stop
- 2004-06-04
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Antonietta Purdy
Record id
062f00f9-5db0-55c4-4c4d-877fe788275c