Claim total
$550.12
base $93.39 · payer covered $440.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-05-14
- Stop
- 2020-05-14
The parties
- Patient
- patient Nicole Kelsi Sipes
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicare
Record id
0cb983be-15db-fabe-5ed2-8dadc5084e1d