Claim total
$182.30
base $93.39 · payer covered $132.30
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-07-19
- Stop
- 2022-07-19
The parties
- Patient
- patient Deetta Domitila Kovacek
- Provider
- provider Damien Mante
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
0cb4c0aa-53a4-1dd6-ae4d-8e02d58cbc58