Claim total
$126.29
base $93.39 · payer covered $101.03
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-06-23
- Stop
- 2019-06-23
The parties
- Patient
- patient Tristan Chase Moore
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer UnitedHealthcare
Record id
3ac7a739-3886-4d55-a656-40736c73f328