Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-10-07
- Stop
- 2018-10-07
The parties
- Patient
- patient Jackie Stevie Bruen
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
18105727-75f2-3289-908b-bb718323bcb0