Claim total
$2,601.09
base $93.39 · payer covered $2,551.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-04-01
- Stop
- 2016-04-01
The parties
- Patient
- patient Adella Portia Wolf
- Provider
- provider Wan Osinski
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
1aecd3e0-487a-0af8-0b93-f407ed804207