Claim total
$4,614.97
base $93.39 · payer covered $4,564.97
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-05-14
- Stop
- 2025-05-14
The parties
- Patient
- patient Santo Lucas Stracke
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
39fd323a-3e7b-6551-1e11-c561ede9e98e