Claim total
$280.86
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2014-07-29
- Stop
- 2014-07-30
The parties
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
0177a0d4-f7b6-3393-c08b-a6f0ac25ae06