Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-03-29
- Stop
- 2019-03-29
The parties
- Patient
- patient Alva Randy Gislason
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
06b076c2-4241-661b-0a27-be2a6b98ffb7