Claim total
$247.89
base $93.39 · payer covered $178.03
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-02-16
- Stop
- 2021-02-16
The parties
- Patient
- patient Byron Randall Prosacco
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
38fd0e51-2dd3-4f63-e0af-13c0659d0240