Claim total
$110.51
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2024-12-26
- Stop
- 2024-12-26
The parties
- Patient
- patient Verona Ginger O'Keefe
- Provider
- provider Bryanna Zieme
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer UnitedHealthcare
Record id
04161a30-0372-a815-0da0-71244fa582c9