Claim total
$219.18
base $93.39 · payer covered $169.18
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-12-04
- Stop
- 2016-12-04
The parties
- Patient
- patient Tyler Auer
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2c70e42f-a392-866e-6439-28bb40e2acde