Claim total
$500.27
base $93.39 · payer covered $450.27
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-04-11
- Stop
- 2022-04-11
The parties
- Patient
- patient Elenore Astrid Ryan
- Provider
- provider Yasmine Shanahan
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2b192cee-fe62-521f-dee9-6641b5da658c