Claim total
$93.39
base $93.39 · payer covered $20.56
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Concussion with no loss of consciousness62106007
- Start
- 2019-05-02
- Stop
- 2019-05-02
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Bryanna Zieme
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-22c3-e524bb039c5e