Claim total
$640.69
base $93.39 · payer covered $590.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2020-08-25
- Stop
- 2020-08-25
The parties
- Patient
- patient Evangeline Kasha Schaden
- Provider
- provider Gwenn Hermann
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
0632026e-bab4-0d77-0576-0776ee073834