Claim total
$157.57
base $93.39 · payer covered $107.57
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-08-08
- Stop
- 2017-08-08
The parties
- Patient
- patient Rodney Ivory Thiel
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
156e8f7c-9830-56b6-c20d-25d0be58dec1