Claim total
$690.29
base $93.39 · payer covered $620.43
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-07-29
- Stop
- 2024-07-29
The parties
- Provider
- provider Nicolas Raynor
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
2123ffbe-dcac-b59c-3752-1023be698c05