Claim total
$99.35
base $93.39 · payer covered $99.35
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2023-12-19
- Stop
- 2023-12-19
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Jong King
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Aetna
Record id
047ee4ec-c50b-b504-2ff9-b4a4474ad47d