Claim total
$2,601.09
base $93.39 · payer covered $1,560.65
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-05-08
- Stop
- 2019-05-08
The parties
- Patient
- patient Orville Everette Wiza
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
0c0a7153-7cec-9b16-b558-22cb32ddc22c