Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1997-10-25
- Stop
- 1997-10-25
The parties
- Patient
- patient Tyesha Stracke
- Provider
- provider Nicolas Raynor
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
32352733-5e06-0dd5-1fb0-fd4b7df64131