Claim total
$560.37
base $93.39 · payer covered $510.37
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-11-17
- Stop
- 2016-11-17
The parties
- Patient
- patient Alpha Fahey
- Provider
- provider Maryam Wolf
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
0d312bb0-9f0e-a43d-20df-e6722bd3b187