Claim total
$3,447.07
base $93.39 · payer covered $3,397.07
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute infective cystitis307426000
- Start
- 2016-10-23
- Stop
- 2016-10-23
The parties
- Patient
- patient Cecilia Botsford
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
046c8377-6cc1-c8f9-7ba3-1d709c4b5c96