Claim total
$315.87
base $93.39 · payer covered $265.87
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Gingivitis66383009
- Start
- 2023-07-01
- Stop
- 2023-07-01
The parties
- Patient
- patient Belva Nadene Kuphal
- Provider
- provider Josh Stamm
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
0430ce7c-cb64-da75-84e2-609b54ea6ce4