Claim total
$297.02
base $93.39 · payer covered $247.02
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2014-09-09
- Stop
- 2014-09-09
The parties
- Provider
- provider Nicolas Raynor
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
010d736c-d81f-3cd7-2619-75884e2d5b0d