Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-04-28
- Stop
- 2025-04-28
The parties
- Patient
- patient Bettyann Wen Howell
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0257a216-88a6-e7f3-2a2e-d6d6f09317c3