Claim total
$94.03
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2024-10-27
- Stop
- 2024-10-27
The parties
- Patient
- patient Tawanna Nedra Kuhlman
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
00508659-1210-a7fa-bca8-39c5f76805e4