Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-09-17
- Stop
- 2020-09-17
The parties
- Patient
- patient Slyvia Natosha Zboncak
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
0725e104-ee96-c3d4-573a-3bf774737a5a