Claim total
$640.69
base $93.39 · payer covered $490.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2022-11-20
- Stop
- 2022-11-20
The parties
- Patient
- patient Jon Lavern Baumbach
- Provider
- provider Bryanna Zieme
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
033f4a7e-c2bc-1f12-5f6f-3d63da7694ec