Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-11-23
- Stop
- 2017-11-23
The parties
- Patient
- patient Isadora Madonna Koss
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Aetna
Record id
2322b960-beaf-9bb3-bb9b-e8b9160a3ada