Claim total
$453.88
base $93.39 · payer covered $403.88
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-09-15
- Stop
- 2018-09-15
The parties
- Patient
- patient Evangeline Farrah Bode
- Provider
- provider Mary Harvey
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
2beddb75-2ebe-b789-b739-b17832958e99