Claim total
$164.21
base $93.39 · payer covered $114.21
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-03-04
- Stop
- 2017-03-04
The parties
- Patient
- patient Merrilee Fidelia Ortiz
- Provider
- provider Verdie Schowalter
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
2a93388c-1013-f887-3ff3-58c9bbcbb8f2