Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-05-13
- Stop
- 2019-05-13
The parties
- Patient
- patient Nestor Dannie Lockman
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1320f2b9-2201-d6ed-385e-289bfc329002