Claim total
$126.29
base $93.39 · payer covered $91.29
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-12-17
- Stop
- 2021-12-17
The parties
- Patient
- patient Lonnie Schroeder
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
30ee6aa0-fa33-9d82-46f2-369ba529ffab