Claim total
$180.64
base $93.39 · payer covered $130.64
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-04-04
- Stop
- 2021-04-04
The parties
- Patient
- patient Angila Delfina Friesen
- Provider
- provider Mary Harvey
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
2fb62ca5-b037-fe29-f65b-e066ec774dd5