Claim total
$2,913.51
base $93.39 · payer covered $2,863.51
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-07-04
- Stop
- 2024-07-04
The parties
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
2b201776-a170-1a2d-bc16-d5b009a0eb58