Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-11-17
- Stop
- 2024-11-17
The parties
- Patient
- patient Vanessa Oleta Stark
- Provider
- provider Charlena Adams
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
17745b72-679e-c608-7ab7-288db5aada2b