Claim total
$299.18
base $93.39 · payer covered $239.34
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2021-07-25
- Stop
- 2021-07-25
The parties
- Patient
- patient Terrance Derek Mueller
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
032e5f12-51a3-9303-6192-50d7b8d39900