Claim total
$369.14
base $93.39 · payer covered $319.14
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-11-19
- Stop
- 2019-11-19
The parties
- Patient
- patient Tyler Auer
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2c70e42f-a392-866e-5cdc-84a389a4e21a