Claim total
$7,150.78
base $93.39 · payer covered $7,100.78
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-10-03
- Stop
- 2020-10-03
The parties
- Patient
- patient Hai Keebler
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
20aaeaae-4348-eb24-8f9f-3c169b31e560