Claim total
$155.66
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 394701000
- Reason
- diagnosis concept Asthma195967001
- Start
- 2020-09-16
- Stop
- 2020-09-16
The parties
- Patient
- patient Amanda Kelsey Daugherty
- Provider
- provider Nicolas Raynor
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Anthem
Record id
00a2ce2f-1e05-ab20-8f00-3ead071fd553