Claim total
$3,241.94
base $93.39 · payer covered $3,206.94
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-12-05
- Stop
- 2017-12-05
The parties
- Patient
- patient Joe Abe Koch
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
20ddca7d-6cee-85eb-3925-26a5a2d75082