Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1989-12-30
- Stop
- 1989-12-30
The parties
- Patient
- patient Soledad Rocio Aguirre
- Provider
- provider Bryanna Zieme
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
060aa7a8-9653-5ae4-b7f6-9d1fe9191bec