Claim total
$7,425.03
base $93.39 · payer covered $7,375.03
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-09-19
- Stop
- 2019-09-19
The parties
- Patient
- patient Steve Barton Schuppe
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0b3d29c0-f753-d097-3aca-ceea61fa3e34