Claim total
$179.26
base $93.39 · payer covered $179.26
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2013-12-01
- Stop
- 2013-12-01
The parties
- Patient
- patient Amelia Danyel Hintz
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
007ab53b-1293-c7a9-7412-b135e1653049