Claim total
$2,601.09
base $93.39 · payer covered $2,551.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-01-17
- Stop
- 2023-01-17
The parties
- Patient
- patient Evangeline Kasha Schaden
- Provider
- provider Maryam Wolf
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
0632026e-bab4-0d77-717f-ddb369ae6510