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
- 2007-11-25
- Stop
- 2007-11-25
The parties
- Patient
- patient Lynn Catrina Keebler
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1ce83e5f-4669-f644-38a2-d0b2a0cb7397