Claim total
$3,223.62
base $93.39 · payer covered $3,173.62
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-10-09
- Stop
- 2018-10-09
The parties
- Patient
- patient Bernetta Dare
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
2253ffad-5335-0a17-fcb1-9bc25a4fd97f