Claim total
$704.86
base $93.39 · payer covered $654.86
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-10-14
- Stop
- 2018-10-14
The parties
- Patient
- patient Treasa Ankunding
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
25570f50-9eb0-6bc1-d67d-54ced5261840