Claim total
$508.23
base $93.39 · payer covered $458.23
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-10-28
- Stop
- 2017-10-28
The parties
- Patient
- patient Tyra Jonie Leannon
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
226e94e3-187e-c212-97e0-9b64d67164b0