Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Asthma195967001
- Start
- 2009-01-17
- Stop
- 2009-01-17
The parties
- Patient
- patient Nelda Flo Smith
- Provider
- provider Shonta Hayes
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
31763af1-0d0a-afc7-463c-c7a0f511a9c4