Claim total
$108.42
base $93.39 · payer covered $86.73
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2018-05-07
- Stop
- 2018-05-07
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Amber Yost
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-f275-7f217d6e82ce