Claim total
$10,124.19
base $93.39 · payer covered $10,074.19
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-06-01
- Stop
- 2018-06-01
The parties
- Patient
- patient Marlin Renato Heller
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
19e6f368-699b-8438-c13b-10092c7d63ca