Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2015-04-18
- Stop
- 2015-04-18
The parties
- Patient
- patient Adrian Grady O'Keefe
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
00a9bdc8-6b4d-5df7-d168-be2c872fdbf6