Claim total
$408.82
base $93.39 · payer covered $408.82
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2019-01-28
- Stop
- 2019-01-28
The parties
- Patient
- patient Aubrey Mattie Turcotte
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
01ad68d8-96ec-fcdf-708e-41570331097f