Claim total
$205.88
base $93.39 · payer covered $164.70
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2016-01-10
- Stop
- 2016-01-10
The parties
- Patient
- patient Denyse Fadel
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Anthem
Record id
048ae427-86b6-6ce9-a45b-7a05e29950b8