Claim total
$155.66
base $155.66 · payer covered $124.53
The visit
- Class
- Ambulatory
- Code
- 394701000
- Reason
- diagnosis concept Asthma195967001
- Start
- 2015-12-28
- Stop
- 2015-12-28
The parties
- Patient
- patient Eliseo Stewart Baumbach
- Provider
- provider Laurence Mosciski
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicare
Record id
047697e3-dcee-86e1-576c-e1e7b5e655d5