Claim total
$126.29
base $93.39 · payer covered $76.29
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1999-02-19
- Stop
- 1999-02-19
The parties
- Patient
- patient Eric Angelina Block
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
1e773422-36b2-4dec-8fc3-4a94b89f5ff0