Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1998-12-02
- Stop
- 1998-12-02
The parties
- Patient
- patient Jami Helen Wisoky
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
24dd8ac8-6bcb-597c-9b3a-8b41fa4a58c0