Claim total
$424.36
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-06-21
- Stop
- 2016-06-21
The parties
- Patient
- patient Jacquelin Leffler
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Aetna
Record id
1238e43a-68f7-e8e8-7c59-f5e1d9c5e2d8