Claim total
$159.49
base $93.39 · payer covered $109.49
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-10-11
- Stop
- 2024-10-11
The parties
- Patient
- patient Evangeline Farrah Bode
- Provider
- provider Odessa Schamberger
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
2beddb75-2ebe-b789-e583-3618b6b82bb1