Claim total
$751.47
base $93.39 · payer covered $701.47
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-10-02
- Stop
- 2020-10-02
The parties
- Patient
- patient Peg Tresa Cummerata
- Provider
- provider Stuart Bergnaum
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
04fb4e35-41c7-7592-6441-ea0d8f74bbb6