Claim total
$359.11
base $93.39 · payer covered $309.11
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-12-25
- Stop
- 2024-12-25
The parties
- Patient
- patient Ria Berge
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
083d4d1d-5f6d-c59b-5fec-e6432559525b