Claim total
$155.66
base $155.66 · payer covered $124.53
The visit
- Class
- Ambulatory
- Code
- 394701000
- Reason
- diagnosis concept Asthma195967001
- Start
- 2023-03-05
- Stop
- 2023-03-05
The parties
- Patient
- patient Amanda Kelsey Daugherty
- Provider
- provider Tyrone Stracke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Anthem
Record id
00a2ce2f-1e05-ab20-6b90-0c2460ec537a