Claim total
$249.28
base $93.39 · payer covered $199.28
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-09-15
- Stop
- 2020-09-15
The parties
- Patient
- patient Nickie Armstrong
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
216dff76-8461-8cb6-83a9-09a51b519d28