Claim total
$510.90
base $93.39 · payer covered $460.90
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-04-24
- Stop
- 2018-04-24
The parties
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0f8011da-3f5b-ae5a-039c-148dc074708a