Claim total
$3,223.62
base $93.39 · payer covered $3,173.62
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1985-08-27
- Stop
- 1985-08-27
The parties
- Patient
- patient Azalee Lura Koepp
- Provider
- provider Carmen Olson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
20852a5c-dbef-c661-f8bf-301c47494140