Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-12-28
- Stop
- 2023-12-28
The parties
- Patient
- patient Johnnie Rashad Pfeffer
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
030fbd6c-bbe4-c142-7ad1-5046f85ef964