Claim total
$5,999.66
base $93.39 · payer covered $5,949.66
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-05-30
- Stop
- 2020-05-30
The parties
- Patient
- patient Shalon Arnetta Bosco
- Provider
- provider Patrick Breitenberg
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03f768f4-038d-f7fd-66e2-032ba9dc91ae