Claim total
$8,334.28
base $93.39 · payer covered $8,284.28
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-01-03
- Stop
- 2019-01-03
The parties
- Patient
- patient Jarvis Konopelski
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2029313b-bf4f-fef4-a6c2-67c1759c857b