Claim total
$123.02
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2017-05-06
- Stop
- 2017-05-07
The parties
- Patient
- patient Latoya Serina Howell
- Provider
- provider Danilo Davis
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Humana
Record id
01a84ea8-c5e2-54d4-fa90-7eb6053280fb