Claim total
$5,285.91
base $93.39 · payer covered $5,235.91
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-01-27
- Stop
- 2018-01-27
The parties
- Patient
- patient Maricela Gaye Labadie
- Provider
- provider Silvana Weber
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
204f0e38-5f88-c3c2-4d31-c91d4d45117d