Claim total
$94.03
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2025-07-23
- Stop
- 2025-07-23
The parties
- Patient
- patient Tim Taylor Terry
- Provider
- provider Antonietta Purdy
- Payer
- payer Humana
Record id
03607fcd-7c51-41c0-b6bc-bfd6a2952f61