Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-06-17
- Stop
- 2018-06-17
The parties
- Patient
- patient Ben Ernesto Rosenbaum
- Provider
- provider Zofia Bosco
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
24f70975-753d-446a-633c-2195335c607c