Claim total
$6,272.10
base $93.39 · payer covered $6,222.10
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2018-04-11
- Stop
- 2018-04-11
The parties
- Patient
- patient Sacha Sharita Hodkiewicz
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
3428133e-e709-f6fe-d27a-ff94f6cad787