Claim total
$565.82
base $93.39 · payer covered $515.82
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-11-08
- Stop
- 2021-11-08
The parties
- Patient
- patient Ka Jacobson
- Provider
- provider Danilo Davis
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
255c6acb-9d44-0232-884a-a2e378c99a6b