Claim total
$915.99
base $93.39 · payer covered $865.99
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute viral pharyngitis195662009
- Start
- 2020-08-27
- Stop
- 2020-08-27
The parties
- Patient
- patient Bernard Gleichner
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
04317637-3b9f-f5e4-5768-800540188953