Claim total
$363.43
base $93.39 · payer covered $313.43
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2015-03-02
- Stop
- 2015-03-02
The parties
- Patient
- patient Zenia Tegan Nolan
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0f1bcaa4-de3d-14e5-f487-0fcbb97e0bbb