Claim total
$474.03
base $93.39 · payer covered $379.22
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2015-02-11
- Stop
- 2015-02-11
The parties
- Patient
- patient Latasha Crist
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0fc193c9-8970-9d72-31d4-e55c851ef7db