Claim total
$4,600.44
base $93.39 · payer covered $425.43
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-04-03
- Stop
- 2022-04-03
The parties
- Patient
- patient Lloyd Rickie Haley
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
1d6b53aa-7b4e-231a-2a7d-451f4b9cf760