Claim total
$126.29
base $93.39 · payer covered $76.29
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2026-07-03
- Stop
- 2026-07-03
The parties
- Patient
- patient Mauricio Lonny Kuhic
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0f485ee8-5d5d-3351-6e39-ad18e5f1539d