Claim total
$126.29
base $93.39 · payer covered $91.29
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-12-18
- Stop
- 2016-12-18
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Grazyna Sauer
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
01e64c71-bb1e-2212-28bc-53916ca9b9ba