Claim total
$157.93
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2023-05-10
- Stop
- 2023-05-10
The parties
- Patient
- patient Lincoln Reyes Hansen
- Provider
- provider Amber Yost
- Payer
- payer Humana
Record id
036e82a1-5d34-0b1d-7a04-7f2515cdeaf1