Claim total
$4,548.44
base $93.39 · payer covered $4,498.44
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-10-18
- Stop
- 2020-10-18
The parties
- Patient
- patient Griselda O'Kon
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
300328e6-1f06-f64e-69d4-7595303918cc