Claim total
$570.83
base $93.39 · payer covered $520.83
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-04-09
- Stop
- 2021-04-09
The parties
- Patient
- patient Calvin Jonathon Fay
- Provider
- provider Will Leuschke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
1d7dcc8a-2226-3c4b-0da9-7b343672f29a