Claim total
$239.80
base $93.39 · payer covered $189.80
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-08-31
- Stop
- 2022-08-31
The parties
- Patient
- patient Dario Vincent Parker
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
2c1ff194-6001-850f-98df-37c58bd4d32f