Claim total
$244.49
base $93.39 · payer covered $194.49
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-09-12
- Stop
- 2021-09-12
The parties
- Patient
- patient Santo Lucas Stracke
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
39fd323a-3e7b-6551-b4e4-4fc2eef8f659