Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2003-03-18
- Stop
- 2003-03-18
The parties
- Patient
- patient Isiah Kurtis Connelly
- Provider
- provider Maryam Wolf
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
3b24d024-a466-fe09-dd65-0ae816defaf4