Claim total
$301.82
base $93.39 · payer covered $241.45
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2009-01-19
- Stop
- 2009-01-19
The parties
- Patient
- patient Lakenya Rowena Yost
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
059f80d2-8b9a-47e2-27a1-85874340b071