Claim total
$226.02
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2016-12-09
- Stop
- 2016-12-09
The parties
- Patient
- patient Josh Monahan
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Cigna Health
Record id
03f57d95-a536-8def-ecf8-7859acd870ae