Claim total
$360.65
base $93.39 · payer covered $288.52
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2015-05-02
- Stop
- 2015-05-02
The parties
- Patient
- patient Preston Santos Lemke
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
256050e0-8358-3f97-4cad-123e3f0be679