Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2015-09-10
- Stop
- 2015-09-10
The parties
- Patient
- patient Briana Alana Hickle
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
0b3b7c16-0bc2-6fa5-bf43-1ea66eeb0e6e