Claim total
$105.49
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2012-08-01
- Stop
- 2012-08-01
The parties
- Patient
- patient Cassie Kristina Hoeger
- Provider
- provider Heriberto Smitham
- Payer
- payer UnitedHealthcare
Record id
0071794d-67c4-c06b-cda6-9694b0db8058