Claim total
$2,601.09
base $93.39 · payer covered $2,551.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-10-09
- Stop
- 2020-10-09
The parties
- Patient
- patient Dusty Tyson Heidenreich
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2cd4188f-31dd-c72f-ed23-57eacf3f6e3e