Claim total
$396.88
base $93.39 · payer covered $346.88
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2022-11-16
- Stop
- 2022-11-16
The parties
- Patient
- patient Sue Hickle
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
201c3454-6429-089f-1f24-ce0f5efb001d