Claim total
$434.81
base $93.39 · payer covered $239.53
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2014-08-19
- Stop
- 2014-08-19
The parties
- Patient
- patient Allan Ivan Kuphal
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
2cc14d47-c00d-f33b-c226-1c2016dd141d