Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2025-04-12
- Stop
- 2025-04-12
The parties
- Patient
- patient Sacha Terica Vandervort
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
202184d8-2aca-1bde-2363-8fdb4f6608d3