Claim total
$111.94
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1937-12-21
- Stop
- 1937-12-21
The parties
- Patient
- patient Astrid Doria Dach
- Provider
- provider Janette Fisher
- Payer
- payer Humana
Record id
02e7d6ac-dd81-002b-ae68-9c22efd26b12