Claim total
$203.49
base $93.39 · payer covered $153.49
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-12-08
- Stop
- 2023-12-08
The parties
- Patient
- patient Antonia Sherwood Schmitt
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1888bd1d-48de-7570-371e-205efe3ffa4c