Claim total
$370.16
base $93.39 · payer covered $267.76
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-12-13
- Stop
- 2020-12-13
The parties
- Patient
- patient Shanon Bosco
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
2a5ad0f4-e50c-87be-c25d-06cc25843c6e