Claim total
$504.69
base $93.39 · payer covered $469.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1993-01-13
- Stop
- 1993-01-13
The parties
- Patient
- patient Bobby Bret Stoltenberg
- Provider
- provider Zofia Bosco
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
2f08bddf-ff57-70bd-1541-42e197a6ff97