Claim total
$99.35
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2013-12-15
- Stop
- 2013-12-15
The parties
- Patient
- patient Terrance Derek Mueller
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
032e5f12-51a3-9303-3def-d5f225ca67b4