Claim total
$751.47
base $93.39 · payer covered $716.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1986-08-16
- Stop
- 1986-08-16
The parties
- Patient
- patient Heike Nelida Olson
- Provider
- provider Joshua Dickens
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
195810b4-1136-614f-fa8e-c576c4cde05f