Claim total
$126.29
base $93.39 · payer covered $76.29
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2026-03-06
- Stop
- 2026-03-06
The parties
- Patient
- patient Sacha Sharita Hodkiewicz
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
3428133e-e709-f6fe-2cf8-8152aec97e93