Claim total
$10,124.19
base $93.39 · payer covered $10,074.19
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-07-20
- Stop
- 2025-07-20
The parties
- Patient
- patient Roderick Lloyd Gottlieb
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
1bef94fd-46c7-91d1-111f-2280bd897480