Claim total
$157.11
base $93.83 · payer covered $107.11
The visit
- Class
- Wellness
- Code
- 308646001
- Reason
- diagnosis concept Ischemic heart disease414545008
- Start
- 1999-12-04
- Stop
- 1999-12-04
The parties
- Patient
- patient Elbert Rod Lemke
- Provider
- provider Will Leuschke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
039e51d1-c563-811d-1ff9-7ca9f883b912