Claim total
$182.65
base $93.39 · payer covered $132.65
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2019-01-06
- Stop
- 2019-01-06
The parties
- Patient
- patient Jon Lavern Baumbach
- Provider
- provider Josh Stamm
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
033f4a7e-c2bc-1f12-53e8-63404cff93e2