Sam Ferreira

Packet ready

72 M · MRN TCPT-0046915 · Prostate adenocarcinoma, favorable intermediate risk, cT1c N0 M0

Humana Gold Plus HMO (Medicare Advantage) · H55120937

Ordered by R. Lee, MD · Sep 2, 2026 · CPT 77523 · C61 Malignant neoplasm of prostate

Sam Ferreira · Humana Gold Plus HMO

Supporting records pulled from G2

ACE read every document in the G2 chart and pulled only what Humana policy HUM-PBRT-DEMO asks for. Each record below says why it is in the packet, what was extracted from it and which criteria it satisfies. Everything else stays in the chart and is listed at the bottom.

Read

documents in G2

Pulled

into the packet

Pages out

sent to the payer

No packet yet

44 documents in G2. Build the packet to see which records ACE pulls and why.

Static sample case — packet building is scripted only for the demo cases