Claim total
$10,124.19
base $93.39 · payer covered $10,074.19
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2021-07-22
- Stop
- 2021-07-22
The parties
- Patient
- patient Desire Suzie Simonis
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
307966cc-34e1-e48c-f8c1-8d3a21530190