Claim total
$180.75
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-04-13
- Stop
- 2022-04-13
The parties
- Patient
- patient Modesto Derick Blanda
- Provider
- provider Clint Witting
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer UnitedHealthcare
Record id
13bbf0ff-280f-8cc9-c9c4-118c14995217