Claim total
$3,738.81
base $93.39 · payer covered $3,703.81
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-12-21
- Stop
- 2016-12-21
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
046903bc-0773-63cf-b68f-911a19d37c02