Claim total
$10,124.19
base $93.39 · payer covered $10,021.79
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-04-21
- Stop
- 2021-04-21
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-e998-eda21f5c9ed1