Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2020-11-28
- Stop
- 2020-11-28
The parties
- Patient
- patient Jay Lawrence Gleichner
- Provider
- provider Lady Frami
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
32da22ea-67d9-8935-49cd-d52729778947