Claim total
$5,790.53
base $93.39 · payer covered $5,740.53
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-07-20
- Stop
- 2019-07-20
The parties
- Patient
- patient Jere Neal Berge
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1d7259f1-41e7-40b7-c01b-a9f0ec0ad5a3