Claim total
$2,698.87
base $93.39 · payer covered $2,616.31
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-03-01
- Stop
- 2020-03-01
The parties
- Patient
- patient Quentin Julius Roberts
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
352df3b7-7347-fd8e-1827-7ded8d4f4dbd