Claim total
$2,601.09
base $93.39 · payer covered $2,551.09
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-11-18
- Stop
- 2021-11-18
The parties
- Patient
- patient Federico Carroll Grady
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0d96c26e-79fa-1a73-a5a5-1fa20fb3c9bc