Claim total
$161.71
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2025-08-13
- Stop
- 2025-08-13
The parties
- Patient
- patient Nona Samara Gleichner
- Provider
- provider Amber Yost
- Payer
- payer Humana
Record id
0042ca65-dd9d-7221-b3b9-4d1c2f19598b