Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-06-28
- Stop
- 2021-06-28
The parties
- Patient
- patient Sebastian Lavern Brown
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
36deb4e8-cfd4-07d1-7652-bfa877f36c7a