Pre-Treatment Benefits

  • Member Name
  • Relationship
  • Dentist
  • Status
  • Date of Service
  • Submitted Charges
  • Benefit Amount
  • Your Responsibility
  • Member Name
    Member Name : {{list.memberName}}
    Relationship
    Relationship: {{list.relationship}}
    Dentist
    Dentist: {{list.dentist}}
    Status
    Status: {{list.status | lowercase}}
    Date of Service
    Date of Service: {{list.dateOfService | date:'MM/dd/yyyy'}}
    Submitted Charges
    Submitted Charges: {{list.submittedCharges | currency}}
    Benefit Amount
    Benefit Amount: {{list.benefitAmt| currency}}
    Your Responsibility
    Your Responsibility: {{list.responsibilityAmt | currency}}
     
    Details

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