Claim total
$125.26
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2016-10-29
- Stop
- 2016-10-29
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-ee6d-4a3c81c5b6c3