Claim total
$166.17
base $93.39 · payer covered $116.17
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-05-01
- Stop
- 2017-05-01
The parties
- Patient
- patient Adena Fahey
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
1ef3fae3-7ac2-b3a6-eec5-5ffcecb9c360