Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Outpatient
- Code
- 185347001
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2017-02-25
- Stop
- 2017-02-25
The parties
- Patient
- patient Hilton Marcelino Friesen
- Provider
- provider Bryanna Zieme
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
069d1f4a-1b6f-6d04-39a6-5df7762aa55e