Claim total
$348.97
base $93.39 · payer covered $279.17
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-08-30
- Stop
- 2025-08-30
The parties
- Patient
- patient Douglas Mose Kertzmann
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
2a999821-d76f-cf16-bcdf-8e457e8f9c7d