Claim total
$883.59
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2021-10-21
- Stop
- 2021-10-22
The parties
- Patient
- patient Latesha Heaney
- Provider
- provider Pa Kulas
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Humana
Record id
02ab4e74-e091-f51b-460f-45a93b2aeacd