Claim total
$2,601.09
base $93.39 · payer covered $2,551.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-07-20
- Stop
- 2023-07-20
The parties
- Patient
- patient Jon Lavern Baumbach
- Provider
- provider Nicolas Raynor
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
033f4a7e-c2bc-1f12-c03a-dbff04721fd5