Claim total
$5,365.75
base $93.39 · payer covered $5,315.75
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2026-03-19
- Stop
- 2026-03-19
The parties
- Patient
- patient Mitch Trey Leannon
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
17228e98-12bd-8e80-4660-ab7e8d784f93