Claim total
$376.31
base $93.39 · payer covered $326.31
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-12-05
- Stop
- 2021-12-05
The parties
- Patient
- patient Warren Marlon Sauer
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
14311efe-7553-1f52-f284-e906337bb7e0