Claim total
$434.61
base $93.39 · payer covered $347.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2011-05-27
- Stop
- 2011-05-27
The parties
- Patient
- patient Jake Jeremy Osinski
- Provider
- provider Charlena Adams
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0dfbe012-8ee8-d7ad-612d-d2836c1d4752