Claim total
$96.68
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1941-09-09
- Stop
- 1941-09-09
The parties
- Patient
- patient Astrid Doria Dach
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Humana
Record id
02e7d6ac-dd81-002b-ab01-feac6599aca9