Claim total
$198.51
base $93.39 · payer covered $158.81
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2016-11-16
- Stop
- 2016-11-16
The parties
- Patient
- patient Delmer Maynard Kris
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0b575b03-961f-f971-3d53-cda57820e687