Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-03-31
- Stop
- 2017-03-31
The parties
- Patient
- patient Ka Jacobson
- Provider
- provider Danilo Davis
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
255c6acb-9d44-0232-6437-6c5831210b17