Claim total
$289.72
base $93.39 · payer covered $239.72
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2022-08-15
- Stop
- 2022-08-15
The parties
- Patient
- patient Samuel Earnest Turcotte
- Provider
- provider Josh Stamm
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
05c29541-7f3e-5d79-a3ea-6f96c3fd6a74