Claim total
$4,001.38
base $93.39 · payer covered $3,966.38
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-04-13
- Stop
- 2021-04-13
The parties
- Patient
- patient Wilfred Dylan Stracke
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
12af9e1b-7bdb-0614-6fbc-7ca542703619