Claim total
$640.69
base $93.39 · payer covered $590.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2020-08-26
- Stop
- 2020-08-26
The parties
- Patient
- patient Ronald Inga Torphy
- Provider
- provider Gwenn Hermann
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
05af61d0-e78c-a60a-0bc6-c822b1a2993a