Claim total
$161.49
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2012-05-23
- Stop
- 2012-05-23
The parties
- Patient
- patient Felipe Dwain Keebler
- Provider
- provider Amber Yost
- Payer
- payer Humana
Record id
02f04cf4-122a-e8d3-fd2e-1a17af3a11a2