Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2020-05-10
- Stop
- 2020-05-10
The parties
- Patient
- patient Demarcus Dicki
- Provider
- provider Maryam Wolf
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
0a62e53f-e649-0fe9-c2e9-a570309de5c1