Claim total
$291.66
base $155.66 · payer covered $241.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2024-01-02
- Stop
- 2024-01-02
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-bab4-0d77-52f5-39ac8a9ab4d8