Claim total
$157.11
base $93.83 · payer covered $107.11
The visit
- Class
- Wellness
- Code
- 308646001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 1992-12-02
- Stop
- 1992-12-02
The parties
- Patient
- patient Susanna Avis Emard
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
0443166c-c803-503e-80c1-d2fb98b56688