Claim total
$116.63
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2019-03-31
- Stop
- 2019-03-31
The parties
- Patient
- patient Tawanna Nedra Kuhlman
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
00508659-1210-a7fa-d88a-872c2e6117d6