Claim total
$414.62
base $93.39 · payer covered $364.62
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2017-09-10
- Stop
- 2017-09-10
The parties
- Patient
- patient Hans Austin Skiles
- Provider
- provider Silvana Weber
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
2a801a9c-9341-ed04-d379-9ab846cd1b68