Claim total
$204.37
base $93.39 · payer covered $154.37
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-11-04
- Stop
- 2025-11-04
The parties
- Patient
- patient Jamee Elenore Wehner
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0fcc090f-1909-c864-a3f1-faf9480c0dea