Claim total
$6,511.69
base $93.39 · payer covered $6,461.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-12-21
- Stop
- 2022-12-21
The parties
- Patient
- patient Dong Borer
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
06fe0fa1-aba9-b4f6-c1c8-e4957adfb3c8