Claim total
$445.37
base $93.39 · payer covered $395.37
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1949-03-08
- Stop
- 1949-03-08
The parties
- Patient
- patient Toshiko Sybil King
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
106257f3-21d9-7a09-84af-1e44d13bd4bb