Claim total
$196.68
base $93.39 · payer covered $94.28
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-12-26
- Stop
- 2023-12-26
The parties
- Patient
- patient Earl Jerome Schmidt
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0d968990-4e91-8a45-cf48-3f9b1eccee75