Claim total
$788.25
base $93.39 · payer covered $630.60
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2025-11-02
- Stop
- 2025-11-02
The parties
- Patient
- patient Tawanna Nedra Kuhlman
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
00508659-1210-a7fa-4209-ce540036dcc1