Claim total
$176.17
base $93.39 · payer covered $126.17
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 1995-08-10
- Stop
- 1995-08-10
The parties
- Provider
- provider Josh Stamm
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
06014704-4726-adb5-6754-21f30abf2203