Claim total
$498.58
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2021-04-19
- Stop
- 2021-04-19
The parties
- Patient
- patient Aubrey Mattie Turcotte
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
01ad68d8-96ec-fcdf-002b-3fef53c71597