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
- 2020-05-05
- Stop
- 2020-05-05
The parties
- Patient
- patient Salina Takako Ondricka
- Provider
- provider Cory Lynch
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
15541585-3618-a727-bdca-35840762d60d