Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-10-05
- Stop
- 2017-10-05
The parties
- Patient
- patient Danial Hal Lang
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
06067a48-9015-34d7-b69e-c1c335e3090d