Claim total
$5,861.78
base $93.39 · payer covered $5,811.78
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-03-18
- Stop
- 2018-03-18
The parties
- Patient
- patient Dane Cyrus Prosacco
- Provider
- provider Danilo Davis
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
08d84e2a-24fc-df43-3e7f-725e1482a76b