Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-12-05
- Stop
- 2020-12-05
The parties
- Patient
- patient Marylynn Cathryn Lehner
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
074da286-03f5-1f7b-1197-59d90926ed5b