Claim total
$220.88
base $93.39 · payer covered $176.70
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2008-01-03
- Stop
- 2008-01-03
The parties
- Patient
- patient Verona Ginger O'Keefe
- Provider
- provider Danilo Davis
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer UnitedHealthcare
Record id
04161a30-0372-a815-a84e-a896bc9d5cf8