Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Ambulatory
- Code
- 308335008
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2023-06-13
- Stop
- 2023-06-13
The parties
- Patient
- patient Belva Nadene Kuphal
- Provider
- provider Nicolas Raynor
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
0430ce7c-cb64-da75-f506-2c84d5175b9f