Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-10-18
- Stop
- 2017-10-18
The parties
- Patient
- patient Jarvis Konopelski
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2029313b-bf4f-fef4-c440-5b3a452fe74c