Claim total
$103.37
base $93.39 · payer covered $82.69
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2017-06-03
- Stop
- 2017-06-03
The parties
- Patient
- patient Heriberto Orval Feest
- Provider
- provider Amber Yost
- Payer
- payer UnitedHealthcare
Record id
04dd6dd9-2faa-05da-7782-c471d8bf74a9