Claim total
$389.84
base $93.39 · payer covered $389.84
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2019-12-28
- Stop
- 2019-12-28
The parties
- Patient
- patient Terrell Doyle Heller
- Provider
- provider Carmine Carter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
0638f9ad-338f-7ad3-cb13-c27f655e44c5