Claim total
$104.03
base $93.39 · payer covered $83.23
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2023-12-21
- Stop
- 2023-12-21
The parties
- Patient
- patient Verona Ginger O'Keefe
- Provider
- provider Laurence Mosciski
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer UnitedHealthcare
Record id
04161a30-0372-a815-739b-4ffcb4d3b7fd