Claim total
$95.80
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2018-08-05
- Stop
- 2018-08-05
The parties
- Patient
- patient Denyse Fadel
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Anthem
Record id
048ae427-86b6-6ce9-76c0-528e109fa3b6