Claim total
$138.82
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2024-08-28
- Stop
- 2024-08-28
The parties
- Patient
- patient Cassie Kristina Hoeger
- Provider
- provider Heriberto Smitham
- Payer
- payer UnitedHealthcare
Record id
0071794d-67c4-c06b-29ef-13d773edc32a