Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-06-16
- Stop
- 2023-06-16
The parties
- Patient
- patient Karl Mickey O'Reilly
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
16f58d27-cd9e-7f53-b8b3-4b16b0c86a84