Claim total
$4,969.31
base $93.39 · payer covered $2,913.16
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-04-12
- Stop
- 2019-04-12
The parties
- Patient
- patient Modesto Derick Blanda
- Provider
- provider Mary Harvey
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer UnitedHealthcare
Record id
13bbf0ff-280f-8cc9-d2f4-f03a454314fb