Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-03-26
- Stop
- 2022-03-26
The parties
- Patient
- patient Marylou Luci Blanda
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
1e1c2fac-caa8-1b64-fa4f-e3cb0c814b07