Claim total
$126.29
base $93.39 · payer covered $76.29
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-01-18
- Stop
- 2024-01-18
The parties
- Patient
- patient Janetta Carisa Murphy
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0f64bcb5-b3ee-f26f-4898-e7f0823029af