Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-01-15
- Stop
- 2017-01-15
The parties
- Patient
- patient Lea Edwina Hand
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
1a0b0fe5-5cd2-3c13-6d0d-0c44a2329439