Claim total
$101.56
base $93.39 · payer covered $81.25
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2022-12-15
- Stop
- 2022-12-15
The parties
- Patient
- patient Verona Ginger O'Keefe
- Provider
- provider Danilo Davis
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer UnitedHealthcare
Record id
04161a30-0372-a815-e37d-e8c4481153a5