Claim total
$127.30
base $93.39 · payer covered $101.84
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-08-30
- Stop
- 2019-08-30
The parties
- Patient
- patient Normand Lucien Harris
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
161d8071-f429-ba77-0cd6-458f7fe841ad