Claim total
$6,574.67
base $93.39 · payer covered $6,539.67
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-11-26
- Stop
- 2019-11-26
The parties
- Patient
- patient Jimmy Leland Hermiston
- Provider
- provider Mario Wilkinson
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
34ccec67-7080-7434-ee39-74d4f75747db