Claim total
$169.52
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2018-06-27
- Stop
- 2018-06-27
The parties
- Patient
- patient Miles Auer
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
02b37b89-9593-6a10-e955-552cf581e2ea