Claim total
$484.53
base $93.39 · payer covered $434.53
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-08-07
- Stop
- 2024-08-07
The parties
- Patient
- patient Toby Leo Doyle
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
303d4f07-b646-9af6-0536-0c12e12589ee