Claim total
$425.28
base $93.39 · payer covered $375.28
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-07-05
- Stop
- 2016-07-05
The parties
- Patient
- patient Nick Mitchell Swift
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
074a3e90-8d35-ba52-373b-0be69999893c