Claim total
$127.34
base $93.39 · payer covered $77.34
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1988-10-25
- Stop
- 1988-10-25
The parties
- Patient
- patient Alyce Cecil Bechtelar
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2668caac-5c8b-f678-3fca-eb34d6dec20d