Claim total
$457.77
base $93.39 · payer covered $407.77
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-04-21
- Stop
- 2022-04-21
The parties
- Patient
- patient Steve Barton Schuppe
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0b3d29c0-f753-d097-1515-89cc8c09a291