Claim total
$159.90
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2025-11-20
- Stop
- 2025-11-21
The parties
- Patient
- patient Latesha Heaney
- Provider
- provider Dorethea Predovic
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Humana
Record id
02ab4e74-e091-f51b-7698-f482dfce9ef6