Claim total
$441.34
base $93.39 · payer covered $308.93
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2016-07-21
- Stop
- 2016-07-21
The parties
- Patient
- patient Tamica Sarita Robel
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
Record id
03563bad-3832-f030-c64e-0309875666a6