Claim total
$2,601.09
base $93.39 · payer covered $2,551.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1995-07-26
- Stop
- 1995-07-26
The parties
- Patient
- patient Gabriella Tianna Rohan
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
27f6a40c-7887-8033-3fbb-75455b172c08