Utilization History
{{preloginError}}
Selected Members
{{item.memberProfile.personName.firstName}} {{item.memberProfile.personName.middleName}} {{item.memberProfile.personName.lastName}}
{{item.memberProfile.personName.firstName}} {{item.memberProfile.personName.middleName}} {{item.memberProfile.personName.lastName}}
Member Information
Member Name:
{{utilization.mName.firstName + ' '+ utilization.mName.lastName}}
Relationship:
{{selectMemberData.memberRelation.codeDesc}}
Search Utilization
{{utilErrorMsg}}
{{oneDateError}}
*From Date:
*To Date:
* Indicates a required field.
| Date of Service | Procedure Code | Procedure Code Description | Tooth Number | Surface | Frequency Limitations | ||
|---|---|---|---|---|---|---|---|
| {{item.serviceDate | date : 'MM/dd/yyyy'}} | {{item.procedure.codeValue}} | {{item.procedure.codeDesc | uppercase}} | {{item.toothRange}} | {{(item.toothSurface).length > 0 ? item.toothSurface : '-'}} | {{item.inNetworkFrequency != null && item.inNetworkFrequency != undefined ? item.inNetworkFrequency : item.outOfNetworkFrequency != null && item.outOfNetworkFrequency != undefined ? item.outOfNetworkFrequency : 'NA'}} | ||