Claim total
$99.53
base $93.39 · payer covered $79.62
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2016-12-31
- Stop
- 2016-12-31
The parties
- Patient
- patient Amanda Kelsey Daugherty
- Provider
- provider Josh Stamm
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Anthem
Record id
00a2ce2f-1e05-ab20-d31b-a62cbdedd6cd