Claim total
$341.08
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2026-05-09
- Stop
- 2026-05-09
The parties
- Patient
- patient Jarred Leon Volkman
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
04a55b5e-c1dc-db1f-f70d-330c8114c4a1