Claim total
$485.68
base $93.39 · payer covered $450.68
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-05-31
- Stop
- 2018-05-31
The parties
- Patient
- patient Augustus Lyman Schmitt
- Provider
- provider Silvana Weber
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Dual Eligible
Record id
11e13b06-cce6-c88c-0b67-dfdab29326f3