Claim total
$11,031.27
base $93.39 · payer covered $10,981.27
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-05-10
- Stop
- 2025-05-10
The parties
- Patient
- patient Marisa Tracee Botsford
- Provider
- provider Ignacio Paredes
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
0f07e26f-2898-bd8c-6c66-98c02aad9cd6