Claim total
$197.43
base $93.39 · payer covered $147.43
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-08-04
- Stop
- 2018-08-04
The parties
- Patient
- patient Casey Lino Russel
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
30523c73-61ea-cd3b-f819-3b40d21ff744