Claim total
$125.93
base $93.39 · payer covered $100.74
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2022-05-30
- Stop
- 2022-05-30
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Amber Yost
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-2dc9-47bc2cd71847