Claim total
$369.18
base $93.39 · payer covered $319.18
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-07-20
- Stop
- 2021-07-20
The parties
- Patient
- patient Isaiah Lesch
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
30fd7e10-dfb5-c4bb-c605-bd3918335a3f