Claim total
$751.47
base $93.39 · payer covered $601.17
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-08-23
- Stop
- 2018-08-23
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-fc4f-9c8463c14c43