Claim total
$645.26
base $93.39 · payer covered $595.26
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-08-17
- Stop
- 2025-08-17
The parties
- Patient
- patient King Jerry Mueller
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
337abc94-45df-d035-cb9c-73067271f5dd