Claim total
$143.92
base $93.39 · payer covered $115.13
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2020-05-18
- Stop
- 2020-05-18
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Amber Yost
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-19ad-c946289863f2