Claim total
$118.33
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2025-12-22
- Stop
- 2025-12-22
The parties
- Patient
- patient Sandy Salvador Will
- Provider
- provider Josh Stamm
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
Record id
05317da0-053c-0c68-e4b1-ea765fd0895f