Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2007-07-10
- Stop
- 2007-07-10
The parties
- Patient
- patient Dominic Christian Metz
- Provider
- provider Dusty Barrows
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
14ebfd5c-f9ec-ad2c-07b8-2040d63bbbe9