Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2024-04-27
- Stop
- 2024-04-27
The parties
- Patient
- patient Emerald Katie Jerde
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
24d0e6e5-8a87-707b-b8a7-c7349fb09ba3