Claim total
$4,568.72
base $93.39 · payer covered $3,654.97
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-01-06
- Stop
- 2018-01-06
The parties
- Patient
- patient Shane Ulysses Corwin
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
10fe28ac-fc4b-0361-8a19-ead6f4c022ac