Claim total
$624.65
base $93.39 · payer covered $499.73
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2016-10-18
- Stop
- 2016-10-18
The parties
- Patient
- patient Nanci Lourie Rath
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
019cb7db-9e62-def9-b9f2-cdd2d6ac9da3