Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-05-12
- Stop
- 2018-05-12
The parties
- Patient
- patient Jesse Lucas Rowe
- Provider
- provider Shonta Hayes
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
16996bed-1187-99fd-8c95-3592d3cad28e