Claim total
$295.02
base $93.39 · payer covered $245.02
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-05-10
- Stop
- 2019-05-10
The parties
- Patient
- patient Doyle Thad Bartoletti
- Provider
- provider Silvana Weber
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
16c956d3-fda8-d605-c4a4-755d13b7f9d0