Claim total
$187.97
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2017-03-30
- Stop
- 2017-03-30
The parties
- Patient
- patient Angelo Muller
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
036bf274-5bd6-d003-44eb-a27b68f7c9de