Claim total
$449.23
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-04-29
- Stop
- 2023-04-29
The parties
- Patient
- patient Long Everette O'Connell
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
2b42a968-c9dc-d930-0232-40e54352472d