Claim total
$422.85
base $93.39 · payer covered $338.28
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 1978-11-22
- Stop
- 1978-11-22
The parties
- Patient
- patient Heike Nelida Olson
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
195810b4-1136-614f-302d-9c4702af71e6