Claim total
$260.25
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2021-04-29
- Stop
- 2021-04-29
The parties
- Patient
- patient Angelo Muller
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
036bf274-5bd6-d003-a268-1b524ecfe1a4