Claim total
$106.51
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2022-06-14
- Stop
- 2022-06-14
The parties
- Patient
- patient Cyndi Tromp
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
01936333-6290-e7a2-3298-f597cd7f0d25