Claim total
$126.29
base $93.39 · payer covered $76.29
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-03-12
- Stop
- 2024-03-12
The parties
- Patient
- patient Jimmy Leland Hermiston
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
34ccec67-7080-7434-bb4b-177fb6aaa2a9