Claim total
$340.20
base $93.39 · payer covered $290.20
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2023-07-28
- Stop
- 2023-07-28
The parties
- Patient
- patient Serafina Dickinson
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0ad0bcc5-9e9c-9616-83b1-7c32694833f1