Claim total
$169.28
base $93.39 · payer covered $119.28
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-03-13
- Stop
- 2019-03-13
The parties
- Patient
- patient Ilene Steuber
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1cab5c3e-320a-1ffa-75d5-aa6840561b76