Claim total
$153.52
base $93.39 · payer covered $14.50
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-08-13
- Stop
- 2018-08-13
The parties
- Patient
- patient Lamar Mark Connelly
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
050746ba-be7e-c592-88ce-83d873b1e194