Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-11-06
- Stop
- 2020-11-06
The parties
- Patient
- patient Domonique Lelia Padberg
- Provider
- provider Grazyna Sauer
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
1cc0cde3-5798-4cc6-32e7-25205f590f83