Claim total
$205.85
base $93.39 · payer covered $164.68
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2021-05-19
- Stop
- 2021-05-19
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Anthem
Record id
0190d3b1-c50c-bf7b-7ede-543dca4e7e6b