Claim total
$723.73
base $93.39 · payer covered $434.23
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2019-12-02
- Stop
- 2019-12-02
The parties
- Patient
- patient Bo Gino Murazik
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
003af57f-1886-144b-101d-8e3001ba7eb7