Claim total
$485.93
base $93.39 · payer covered $435.93
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-04-06
- Stop
- 2020-04-06
The parties
- Patient
- patient Sherill Ingeborg Wyman
- Provider
- provider Yasmine Shanahan
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
03eccc4c-a1c4-14ad-05fe-464d6dd982c3