Claim total
$365.71
base $93.39 · payer covered $315.71
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-07-18
- Stop
- 2024-07-18
The parties
- Patient
- patient Hien Shasta Nikolaus
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
1feed5c5-ef44-d1c7-5547-045c0b6c8b98