Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Inpatient
- Code
- 56876005
- Reason
- diagnosis concept Dependent drug abuse6525002
- Start
- 1990-06-04
- Stop
- 1990-06-05
The parties
- Patient
- patient Santa Antonina Bernier
- Provider
- provider Florencio Koepp
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
051f1153-ae45-1425-b940-3ab585e45fc0