Claim total
$435.73
base $93.39 · payer covered $348.58
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-02-18
- Stop
- 2020-02-18
The parties
- Patient
- patient Donita Kasandra Crooks
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
277f7208-da9a-7c08-dfc4-49c2f901e2b7