Claim total
$167.41
base $93.39 · payer covered $117.41
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-01-27
- Stop
- 2020-01-27
The parties
- Patient
- patient Jo Bettyann Durgan
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
09f0f2d1-be2b-4994-669a-d568673848d7