Claim total
$218.64
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2017-04-15
- Stop
- 2017-04-15
The parties
- Patient
- patient Jarred Leon Volkman
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
04a55b5e-c1dc-db1f-c32e-1ced31576503