Claim total
$3,182.12
base $93.39 · payer covered $494.20
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-03-27
- Stop
- 2021-03-27
The parties
- Patient
- patient Lizette Ardella Dicki
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Cigna Health
Record id
31c17b80-43b3-1002-5e2f-cf6ccd5be02a