Claim total
$9,745.41
base $93.39 · payer covered $9,710.41
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-09-07
- Stop
- 2023-09-07
The parties
- Patient
- patient Elijah Ellis Skiles
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
29599f43-c6ee-475e-8491-08c233854e97