Claim total
$151.49
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2020-07-24
- Stop
- 2020-07-24
The parties
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Anthem
Record id
02e77898-0a14-d00d-0db0-260127783179