Claim total
$245.12
base $93.39 · payer covered $195.12
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2019-07-01
- Stop
- 2019-07-01
The parties
- Patient
- patient Antonio Joaquín Laboy
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
24fa995d-fe6c-de32-b9c9-721626d785fa