Claim total
$95.79
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2025-03-03
- Stop
- 2025-03-03
The parties
- Patient
- patient Aubrey Mattie Turcotte
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
01ad68d8-96ec-fcdf-fba4-37a88d1777c3