Claim total
$3,813.35
base $93.39 · payer covered $3,763.35
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-05-03
- Stop
- 2020-05-03
The parties
- Patient
- patient Tamra Darlena Feeney
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
39f891f2-42e3-2507-07e7-35b5fd9daea0