Claim total
$95.90
base $93.39 · payer covered $45.90
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- procedure concept Patient referral for dental care103697008
- Start
- 2003-06-11
- Stop
- 2003-06-11
The parties
- Provider
- provider Josh Stamm
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
010d736c-d81f-3cd7-a967-39445ef7c8c0