Claim total
$125.55
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2006-07-09
- Stop
- 2006-07-09
The parties
- Patient
- patient Terrance Derek Mueller
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
032e5f12-51a3-9303-0cf7-c7a7ae8a0af9