Claim total
$391.30
base $93.39 · payer covered $341.30
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1988-11-16
- Stop
- 1988-11-16
The parties
- Patient
- patient Isreal Eliseo Weissnat
- Provider
- provider Danilo Davis
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
39385208-9399-e36e-d07c-6d5a706e0b2a