Claim total
$504.69
base $93.39 · payer covered $354.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Dependent drug abuse6525002
- Start
- 2019-12-12
- Stop
- 2019-12-12
The parties
- Patient
- patient Jon Lavern Baumbach
- Provider
- provider Jacobo Gallegos
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
033f4a7e-c2bc-1f12-bb69-975af6ff8644