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
- 2025-02-02
- Stop
- 2025-02-02
The parties
- Patient
- patient Lacresha Mandy Labadie
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
33029919-e5ea-d866-8e43-a1cfda48a01b