Claim total
$93.47
base $93.39 · payer covered $43.47
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2020-09-01
- Stop
- 2020-09-01
The parties
- Patient
- patient Evangeline Kasha Schaden
- Provider
- provider Josh Stamm
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
0632026e-bab4-0d77-2564-1f2fe04a180a