Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1985-08-22
- Stop
- 1985-08-22
The parties
- Patient
- patient Nelda Flo Smith
- Provider
- provider Will Leuschke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
31763af1-0d0a-afc7-9fed-d4ca3342243c