Claim total
$155.66
base $155.66 · payer covered $39.86
The visit
- Class
- Ambulatory
- Code
- 394701000
- Reason
- diagnosis concept Asthma195967001
- Start
- 2016-06-27
- Stop
- 2016-06-27
The parties
- Patient
- patient Eliseo Stewart Baumbach
- Provider
- provider Danilo Davis
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicare
Record id
047697e3-dcee-86e1-6fa2-c65132666f09