Claim total
$93.39
base $93.39 · payer covered $17.08
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-05-21
- Stop
- 2025-05-21
The parties
- Patient
- patient Andrés Adán Urías
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0b08a4de-affd-6caf-595a-68e68386d33e