Claim total
$348.53
base $93.39 · payer covered $298.53
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2013-10-16
- Stop
- 2013-10-16
The parties
- Patient
- patient Irvin Anibal Jenkins
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
0a444a8e-d682-af54-abbb-2629f9c1e91f