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
- 2020-10-03
- Stop
- 2020-10-03
The parties
- Patient
- patient Matt Stanton Brown
- Provider
- provider Federico Santiago
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
04e52287-fbd6-ff57-b531-494b2ed55950