Claim total
$414.28
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2017-11-16
- Stop
- 2017-11-16
The parties
- Patient
- patient Verona Ginger O'Keefe
- Provider
- provider Bryanna Zieme
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer UnitedHealthcare
Record id
04161a30-0372-a815-2c16-c6416167ac04