Claim total
$10,124.19
base $93.39 · payer covered $6,074.51
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-04-05
- Stop
- 2022-04-05
The parties
- Patient
- patient Martín Agustín Estrada
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
0c77f232-d1be-55d2-fd11-98795e1cda43