Claim total
$125.26
base $93.39 · payer covered $75.15
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2020-04-06
- Stop
- 2020-04-06
The parties
- Patient
- patient Leif Darren West
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
04bc601b-5b17-3710-3af9-f9a97ce53d67