Claim total
$420.14
base $93.39 · payer covered $420.14
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-10-31
- Stop
- 2021-10-31
The parties
- Patient
- patient Herminia Evelyn Tillman
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer UnitedHealthcare
Record id
10e50578-2bab-6f42-a69c-f4c019cc8b2b