Claim total
$627.83
base $93.39 · payer covered $577.83
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-12-06
- Stop
- 2025-12-06
The parties
- Patient
- patient Calvin Jonathon Fay
- Provider
- provider Will Leuschke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
1d7dcc8a-2226-3c4b-2f90-513e451483db