Claim total
$180.53
base $93.39 · payer covered $144.42
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2018-08-22
- Stop
- 2018-08-22
The parties
- Patient
- patient Cassie Kristina Hoeger
- Provider
- provider Heriberto Smitham
- Payer
- payer UnitedHealthcare
Record id
0071794d-67c4-c06b-457d-084b14585c23